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01-04-2017 | Original Paper

Uterine fibroid therapy using interventional radiology mini-invasive treatments: current perspective

Authors: Carlo Masciocchi, Francesco Arrigoni, Fabiana Ferrari, Aldo Victor Giordano, Sonia Iafrate, Ilaria Capretti, Ester Cannizzaro, Alfonso Reginelli, Anna Maria Ierardi, Chiara Floridi, Alessio Salvatore Angileri, Luca Brunese, Antonio Barile

Published in: Medical Oncology | Issue 4/2017

Abstract

Uterine fibroids are common benign tumors of unclear etiopathology that affect the female reproductive tract. They are responsible for considerable morbidity and deterioration of life quality, and may have a negative impact on the reproductive system as well. Besides surgery aided by uterus-saving techniques, several minimally invasive procedures are now available within the field of interventional radiology that represent a valid solution for women who desire pregnancy and relief from disease-specific symptomatology. The main advantages offered by these techniques are low grade of invasiveness and short times of hospitalization. The most diffuse techniques are uterine artery embolization (UAE) and magnetic resonance-guided high-intensity focused ultrasound (MRgFUS). UAE is an endovascular procedure whose goal is obtained by provoking ischemia of the uterine vessels. MRgFUS is a thermoablation procedure that selectively ablates the symptomatic fibroids. In this review study, both procedures will be described, including a description of technical details, indications, contraindications, complications, and outcomes.

Doina SJ, Minnie M, Sahadat N, William HC. Myometrial cells undergo fibrotic transformation under the influence of transforming growth factor β-3. Fertil Steril. 2010;93(5):1500–8.CrossRef

Najjar M, Mandel M. Case report round ligament leiomyoma presenting as an incarcerated inguinal hernia: case report and review of the literature. Case Reports in Surgery Volume 2016, Article ID 9380212, 3 pages. doi:10.1155/2016/9380212.

Bulun SE. Uterine fibroids. N Engl J Med. 2013;369:1344–55. doi:10.1056/NEJMra1209993.CrossRefPubMed

Parker WH. Etiology, symptomatology, and diagnosis of uterine myomas. Fertil Steril. 2007;87(4):725–36.CrossRefPubMed

Ciavattini A, Di Giuseppe J, Stortoni P, Montik N, Giannubilo SR, Litta P et al. Uterine Fibroids: Pathogenesis and Interactions with Endometrium and Endomyometrial Junction. Obstetrics and Gynecology International Volume 2013, ArticleID 173184, 11 pages. doi:10.1155/2013/173184.

Khan AT, Shehmar M. Gupta JK Uterine fibroids: current perspectives. Int J Women’s Health. 2014;6:95–114.CrossRef

Sparic R, Mirkovic L, Malvasi A, Tinelli A. Epidemiology of uterine myomas: a review. Int J Fertil Steril. 2016;9(4):424–35.PubMed

Stewart EA. Uterine fibroids. N Engl J Med. 2015;372:1646–55. doi:10.1056/NEJMcp1411029.CrossRefPubMed

Olejek A, Olszak-Wąsik K, Czerwinska-Bednarska A. Long-term intermittent pharmacological therapy of uterine fibroids—a possibility to avoid hysterectomy and its negative consequences. Menopause Rev. 2016;15(1):48–51. doi:10.5114/pm.2016.58774.CrossRef

10.

Mukhopadhaya N, Pokuah Asante G, ManyondaI T. Uterine fibroids: impact on fertility and pregnancy loss. Obstet Gynaecol Reprod Med. 2007;17:311–7.CrossRef

11.

Griffin Y, Sudigali V, Jacques A. Radiology of benign disorders of menstruation. Semin ultrasound CT MRI. 2010;. doi:10.1053/j.sult.2010.08.001.

12.

Salvati F, Rossi F, Limbucci N, Pistoia ML, Barile A, Masciocchi C. Mucoid metaplastic-degeneration of anterior cruciate ligament. J Sports Med Phys Fitn. 2008;48(4):483–7.

13.

Ripani M, Continenza MA, Cacchio A, Barile A, Parisi A, De Paulis F. The ischiatic region: normal and MRI anatomy. J Sports Med Phys Fit. 2006;46(3):468–75.

14.

Barile A, Lanni G, Conti L, Mariani S, Calvisi V, Castagna A, Rossi F, Masciocchi C. Lesions of the biceps pulley as cause of anterosuperior impingement of the shoulder in the athlete: potentials and limits of MR arthrography compared with arthroscopy. Radiol Med. 2013;118(1):112–22. doi:10.1007/s11547-012-0838-2.CrossRefPubMed

15.

Zappia M, Reginelli A, Russo A, D’Agosto GF, Di Pietto F, Genovese EA, Coppolino F, Brunese L. Long head of the biceps tendon and rotator interval. Musculoskelet Surg. 2013;97(Suppl 2):S99–108. doi:10.1007/s12306-013-0290-z.CrossRefPubMed

16.

Masciocchi C, Barile A, Lelli S, Calvisi V. Magnetic resonance imaging (MRI) and arthro-MRI in the evaluation of the chondral pathology of the knee joint. Radiol Med. 2004;108(3):149–58.PubMed

17.

Splendiani A, Perri M, Grattacaso G, Di Tunno V, Marsecano C, Panebianco L, Gennarelli A, Felli V, Varrassi M, Barile A, Di Cesare E, Masciocchi C, Gallucci M. Magnetic resonance imaging (MRI) of the lumbar spine with dedicated G-scan machine in the upright position: a retrospective study and our experience in 10 years with 4305 patients. Radiol Med. 2016;121(1):38–44. doi:10.1007/s11547-015-0570-9.CrossRefPubMed

18.

Splendiani A, Ferrari F, Barile A, Masciocchi C, Gallucci M. Occult neural foraminal stenosis caused by association between disc degeneration and facet joint osteoarthritis: demonstration with dedicated upright MRI system. Radiol Med. 2014;119(3):164–74. doi:10.1007/s11547-013-0330-7.CrossRefPubMed

19.

Barile A, Limbucci N, Splendiani A, Gallucci M, Masciocchi C. Spinal injury in sport. Eur J Radiol. 2007 Apr;62(1):68-78. Review. PMID: 17329056.

20.

Caranci F, Tedeschi E, Leone G, Reginelli A, Gatta G, Pinto A, Squillaci E, Briganti F, Brunese L. Errors in neuroradiology. Radiol Med. 2015;120(9):795–801. doi:10.1007/s11547-015-0564-7.CrossRefPubMed

21.

Masciocchi C, Lanni G, Conti L, Conchiglia A, Fascetti E, Flamini S, Coletti G, Barile A. Soft-tissue inflammatory myofibroblastic tumors (IMTs) of the limbs: potential and limits of diagnostic imaging. Skeletal Radiol. 2012;41(6):643–9. doi:10.1007/s00256-011-1263-7.CrossRefPubMed

22.

Zoccali C, Rossi B, Zoccali G, Barbarino E, Gregori L, Barile A, Masciocchi C. A new technique for biopsy of soft tissue neoplasms: a preliminary experience using MRI to evaluate bleeding. Minerva Med. 2015;106(2):117–20.PubMed

23.

Barile A, Regis G, Masi R, Maggiori M, Gallo A, Faletti C, Masciocchi C. Musculoskeletal tumours: preliminary experience with perfusion MRI. Radiol Med. 2007;112(4):550–61.CrossRefPubMed

24.

Aliprandi A, Di Pietto F, Minafra P, Zappia M, Pozza S, Sconfienza LM. Femoro-acetabular Impingement: what the general radiologist should know. Radiol Med. 2014;119(2):103–12. doi:10.1007/s11547-013-0314-7.CrossRefPubMed

25.

Wamsteker K, Emanuel MH, de Kruif JH. Transcervical hysteroscopic resection of submucous fibroids for abnormal uterine bleeding: results regarding the degree of intramural extension. Obstet Gynecol. 1993;82:736–40.PubMed

26.

Munro MG, Critchley HO, Broder MS, Fraser IS. The FIGO classification system (‘‘PALM-COEIN’’) for causes of abnormal uterine bleeding in non-gravid women in the reproductive years, including guidelines for clinical investigation. Int J Gynaecol Obstet. 2011;113:3–13.CrossRefPubMed

27.

Lasmar RB, Barrozo PR, Dias R, Oliveira MA. Submucous myomas: a new presurgical classification to evaluate the viability of hysteroscopic surgical treatment–preliminary report. J Minim Invasive Gynecol. 2005;12:308–11.CrossRefPubMed

28.

Mc Lucas B. Diagnosis, imaging and anatomical classification of uterine fibroids. Best Pract Res Clin Obstet Gynaecol. 2008;22(4):627–42. doi:10.1016/j.bpobgyn.2008.01.006.CrossRef

29.

Article Special. AAGL practice report: practice guidelines for the diagnosis and management of submucous leiomyomas. j minim invasive gynecol. 2012;. doi:10.1016/j.jmig.2011.09.005.

30.

Floridi C, Radaelli A, Abi-Jaoudeh N, Grass M, Lin M, Chiaradia M, Geschwind JF, Kobeiter H, Squillaci E, Maleux G, Giovagnoni A, Brunese L, Wood B, Carrafiello G, Rotondo A. C-arm cone-beam computed tomography in interventional oncology: technical aspects and clinical applications. Radiol Med. 2014;119(7):521–32. doi:10.1007/s11547-014-0429-5.CrossRefPubMedPubMedCentral

31.

Carrafiello G, Fontana F, Cotta E, Petullà M, Brunese L, Mangini M, Fugazzola C. Ultrasound-guided thermal radiofrequency ablation (RFA) as an adjunct to systemic chemotherapy for breast cancer liver metastases. Radiol Med. 2011;116(7):1059–66. doi:10.1007/s11547-011-0697-2.CrossRefPubMed

32.

Cazzato RL, Garnon J, Ramamurthy N, Koch G, Tsoumakidou G, Caudrelier J, Arrigoni F, Zugaro L, Barile A, Masciocchi C, Gangi A. Percutaneous image-guided cryoablation: current applications and results in the oncologic field. Med Oncol. 2016;33(12):140.CrossRefPubMed

33.

Carrafiello G, Fontana F, Mangini M, Ierardi AM, Cotta E, Floridi C, Piacentino F, Fugazzola C. Initial experience with percutaneous biopsies of bone lesions using XperGuide cone-beam CT (CBCT): technical note. Radiol Med. 2012;117(8):1386–97.CrossRefPubMed

34.

Briganti F, Napoli M, Leone G, Marseglia M, Mariniello G, Caranci F, Tortora F, Maiuri F. Treatment of intracranial aneurysms by flow diverter devices: long-term results from a single center. Eur J Radiol. 2014;83(9):1683–90. doi:10.1016/j.ejrad.2014.05.029.CrossRefPubMed

35.

Singh SS, Belland L. Contemporary management of uterine fibroids: focus on emerging medical treatments. Curr Med Res Opin. 2015;31(1):1–12. doi:10.1185/03007995.2014.982246.CrossRefPubMed

36.

Kido A, Ascher SM, Kishimoto K, Hahn W, Jha RC, Togashi K, et al. Comparison of uterine peristalsis before and after uterine artery embolization at 3-T MRI. AJR. 2011;196:1431–5.CrossRefPubMed

37.

Obele CC, Dunham S, Bennett G, Pagan J, Sung LY and Charles HW. Hindawi Case Report A Case of Pyomyoma following Uterine Fibroid Embolization and a Review of the Literature Publishing Corporation Case Reports in Obstetrics and Gynecology Volume 2016, Article ID 9835412, 5 pages. doi:10.1155/2016/9835412.

38.

Bulman JC, Ascher SM, Spies JB. Current concepts in uterine fibroid embolization. Radiographics. 2012;32:1735–50.CrossRefPubMed

39.

Kröncke T, David M. Uterine artery embolization (UAE) for fibroid treatment–results of the 5th Radiological Gynecological Expert Meeting. Fortschr Röntgenstr. 2015;187:483–5. doi:10.1055/s-0034-1399345.CrossRef

40.

Machan L, Martin M. Uterine artery embolization to treat uterine fibroids. Can Assoc Radiol J. 2001;52(3):183.PubMed

41.

Subramaniam RN, Vijayananthan A, Omar SZ, Nawawi O, Abdullah BJJ. Uterine artery embolisation for symptomatic fibroids: the University of Malaya Medical Centre experience. Biomed Imaging Interv J. 2010;6(3):e27.CrossRefPubMedPubMedCentral

42.

Bhardwaj R. Uterine artery embolisation. Indian Heart J. 2012;6403:305–8.CrossRef

43.

Gupta JK, Sinha A, Lumsden MA, Hickey M. Uterine artery embolization for symptomatic uterine fibroids (Review). Cochrane Database of Systematuc Reviews 2014, Issue 12.Art. no.:CD005073. doi:10.1002/14651858.CD005073.pub4.

44.

Mara M, Kubinova K. Embolization of uterine fibroids from the point of view of the gynecologist: pros and cons. Int J Women’s Health. 2014;. doi:10.2147/IJWH.S43591.

45.

Torre A, Paillusson B, Fain V, Labauge P, Pelage JP, Fauconnier A. Uterine artery embolization for severe symptomatic fibroids: effects on fertility and symptoms. Hum Reprod. 2014;29(3):490–501. doi:10.1093/humrep/det459.CrossRefPubMed

46.

Memtsa M, Homer H Complications associated with uterine artery embolisation for fibroids. Hindawi Publishing Corporation Obstetrics and Gynecology International Volume 2012, Article ID 290542, 5 pages doi:10.1155/2012/290542.

47.

Firouznia K, Ghanaati H, Jalali AH, Shakiba M. Uterine artery embolization for treatment of symptomatic fibroids: a review of the Evidence. Iran Red Cres Med J. 2013;15(12):e16699. doi:10.5812/ircmj.16699.CrossRef

48.

Czuczwar P, Woźniak S, Szkodziak P, Woźniakowska E, Paszkowski M, Wrona W, et al. Predicting the results of uterine artery embolization: correlation between initial intramural fibroid volume and percentage volume decrease. Menopauzalny. 2014;13(4):247–52. doi:10.5114/pm.2014.45001.

49.

Scheurig-Muenkler C, Lembcke A, Froeling V, Maurer M, Hamm B, Kroencke TJ. Uterine artery embolization for symptomatic fibroids: long-term changes in disease-specific symptoms and quality of life. Hum Reprod. 2011;26(8):2036–42. doi:10.1093/humrep/der170.CrossRefPubMed

50.

Goldman KN, Hirshfeld-Cytrona JE, Pavonea ME, Thomasa AP, Vogelzangb RL, Milada MP. Uterine artery embolization immediately preceding laparoscopic myomectomy. Int J Gynaecol Obstet. 2012;116(2):105–8. doi:10.1016/j.ijgo.2011.08.022.CrossRefPubMed

51.

Van Ha TG, Li N. Clinical care of patients undergoing uterine artery embolization. Semin Intervent Radiol. 2006;23:350–6. doi:10.1055/s-2006-957025.CrossRefPubMedPubMedCentral

52.

Stott D, Zakaria M. Reminder of important clinical lesson. The transcervical expulsion of a large fibroid. BMJ C rep. 2012;. doi:10.1136/bcr.01.2012.5523.

53.

Bonduki CE, Feldner PC, da Silva J, Castro RA, Sartori MGF, Gira MJBC. Pregnancy after uterine arterial embolization. CLINICS. 2011;66(5):807–10. doi:10.1590/S1807-59322011000500016.CrossRefPubMedPubMedCentral

54.

Lopes HI, Sá MI, Rodrigues RM Case report pregnancy after uterine artery embolization: A case report in a woman with leiomyomata. Case reports in Obstetrics and Gynecology. Volume 2015, article ID 235312, 3 pages. doi:10.1155/2015/235312.

55.

Kitson SJ, Macphail S, Bulmerb J. Is pregnancy safe after uterine artery embolisation? BJOG. 2012;119:519–21. doi:10.1111/j.1471-0528.2012.03286.x.CrossRefPubMed

56.

Zlotnik E, de Lorenzo Messina M, Nasser F, Affonso BB, Baroni RH, Wolosker N, et al. Predictive factors for pelvic magnetic resonance in response to arterial embolization of a uterine leiomyoma. CLINICS. 2014;69(3):185–9. doi:10.6061/clinics/2014(03)07.CrossRefPubMedPubMedCentral

57.

Tomislav S, Josip M, Liana CS, Marko V, Marko J, Ante R et al. Uterine artery embolization as nonsurgical treatment of uterine myomas. International Scholarly Research Network ISRN Obstetrics and Gynecology, Volume 2011, Article ID 489281, 4 pages doi:10.5402/2011/489281.

58.

Tempany CM. Image-guided thermal therapy of uterine fibroids. RadioGraphics. 2007;27:1819–26. doi:10.1148/rg.276075096.CrossRefPubMed

59.

Gorny KR, Borah BJ, Weaver AL, Brown D, Woodrum DA, et al. Clinical predictors of successful magnetic resonance-guided Focused Ultrasound (MRgFUS) for uterine leiomyoma. J Ther Ultrasound. 2013;1:15.CrossRefPubMedPubMedCentral

60.

Cho JY, Kim SH, Kim SY, Moon SK, Li J. Efficacy and safety of daily repeated sonographically guided high-intensity focused ultrasound treatment of uterine fibroids preliminary study. J Ultrasound Med. 2013;32:397–406.CrossRefPubMed

61.

Napoli A, Anzidei M, Ciolina F, Marotta E, Cavallo Marincola B, Brachetti G, et al. MR-guided high-intensity focused ultrasound: current status of an emerging technology. Cardiovasc Intervent Radiol. 2013;. doi:10.1007/s00270-013-0592-4.

62.

Masciocchi C, Conchiglia A, Gregori LM, Arrigoni F, Zugaro L, Barile A. Critical role of HIFU in musculoskeletal interventions. Radiol Med. 2014;119(7):470–5. doi:10.1007/s11547-014-0414-z.CrossRefPubMed

63.

Masciocchi C, Zugaro L, Arrigoni F, et al. Radio frequency ablation versus magnetic resonance guided focused ultrasound surgery for minimally invasive treatment of osteoid osteoma: a propensity score matching study. Eur Radiol. 2016;26:2472–81.CrossRefPubMed

64.

Masciocchi C, Arrigoni F, La Marra A, Mariani S, Zugaro L, Barile A. Treatment of focal benign lesions of the bone: MRgFUS and RFA. Br J Radiol. 2016;89:20150356.CrossRefPubMed

65.

Arrigoni F, Gregori LM, Zugaro L, Barile A, Masciocchi C. MRgFUS in the treatment of MSK lesions: a review based on the experience of the University of L’Aquila, Italy. Transl Cancer Res. 2014;. doi:10.3978/j.issn.2218.

66.

Ferrari F, Arrigoni F, Miccoli A, Mascaretti S, Fascetti E, Mascaretti G, et al. Effectiveness of Magnetic Resonance guided Focused Ultrasound Surgery (MRgFUS) in the uterine adenomyosis treatment: technical approach and MRI evaluation. Radiol med. 2016;121:153–61. doi:10.1007/s11547-015-0580-7.CrossRefPubMed

67.

Pron G. Magnetic Resonance-Guided High-Intensity Focused Ultrasound (MRgHIFU) treatment of symptomatic uterine fibroids: an evidence-based analysis. Ont Health Technol Assess Ser. 2015;15(4):1–86.

68.

Mindjuk I, Trumm CG, Herzog P, Stahl R, Matzko M. MRI predictors of clinical success in MR-Guided Focused Ultrasound (MRgFUS) treatments of uterine fibroids: results from a single centre. Eur Radiol. 2015;25:1317–28. doi:10.1007/s00330-014-3538-6.CrossRefPubMed

69.

Fischer K, McDannold NJ, Tempany CM, Jolesz FA, Fenness FM. Potential of minimally invasive procedures in the treatment of uterine fibroids: a focus on magnetic resonance-guided focused ultrasound therapy. Int J Women’s Health. 2015;7:901–12.

70.

Kröncke T, David M. Magnetic resonance guided focused ultrasound for fibroid treatment. Results of the Second Radiological Gynecological Expert Meeting. Fortschr Röntgenstr. 2015;187:480–2.CrossRef

71.

Roberts A. Magnetic resonance-guided focused ultrasound for uterine fibroids. Semin intervent radiol. 2008;. doi:10.1055/s-0028-1102999.PubMedPubMedCentral

72.

Mahmoud MZ, Alkhorayef M, Alzimami KS, Aljuhani MS, Sulieman A. High-Intensity Focused Ultrasound (HIFU) in uterine fibroid treatment: review study. Pol J Radiol. 2014;79:384–90. doi:10.12659/PJR.891110.CrossRefPubMedPubMedCentral

73.

Nyapathy V, Polina L. MRgFUS treatment of uterine fibroid in a nulliparous woman with acute retention of urine. Obstet Gynecol Radiol Radiol C. 2012;6(2):1–8. doi:10.3941/jrcr.v6i2.809.

74.

Schlesinger D, Benedict S, Diederich C, Gedroyc W, Klibanov A, Larner J. MR-guided focused ultrasound surgery, present and future. Med Phys. 2013;. doi:10.1118/1.4811136.PubMedPubMedCentral

75.

Rueff LE, Raman SS. Clinical and technical aspects of MR-guided high intensity focused ultrasound for treatment of symptomatic uterine fibroids. Semin Intervent Radiol. 2013;30:347–53.CrossRefPubMedPubMedCentral

76.

Leung JHY, Yu SCH, Cheung ECW, Wong ASW, Tong MMB, Ho SSY, et al. Safety and efficacy of sonographically guided high-intensity focused ultrasound for symptomatic uterine fibroids. J Ultrasound Med. 2014;. doi:10.7863/ultra.33.10.1811.

77.

Rice KE, Secrist JR, Woodrow EL, Hallock LM, Neal JL. Etiology, diagnosis, and management of uterine leiomyomas. J Midwifery Women’s Health. 2012;57:241–7. doi:10.1111/j.1542-201.2012.00176.CrossRef

78.

Hesley GK, Felmlee JP, Gebhart JB, Dunagan KT, Gorny KR, Kesler JB, et al. Non invasive treatment of uterine fibroids: early Mayo Clinic experience with magnetic resonance imaging-guided focused ultrasound. Mayo Clin Proc. 2006;81(7):936–42.CrossRefPubMed

79.

Coakley FV, Foster BR, Farsad K, Hung AY, Wilder KJ, Amling CL, et al. Pelvic applications of MR-guided high intensity focused ultrasound. Abdom Imaging. 2013;38:1120–9. doi:10.1007/s00261-013-9999-2.CrossRefPubMed

80.

Liu J, Weib J, Kesercic B, Zhang J, Yanga X, Wang X. T2*-weighted imaging in the assessment of the non-perfused volume of uterine fibroids following magnetic resonance-guided high-intensity focused ultrasound ablation. Int J Gynecol Obstet. 2016;132:100–2. doi:10.1016/j.ijgo.2015.07.005.CrossRef

81.

Zhao WP, Chen JY, Chen WZ. Dynamic contrast-enhanced MRI serves as a predictor of HIFU treatment out come for uterine fibroids with hyperintensity in T2-weighted images. Exp ther med. 2016;11:328–34. doi:10.3892/etm.2015.2879.PubMed

82.

Machtinger R, Inbar Y, Cohen-Eylon S, Admon D, Alagem-Mizrachi A, Rabinovici J. MR-guided focus ultrasound (MRgFUS) for symptomatic uterine fibroids: predictors of treatment success. Hum Reprod. 2012;27(12):3425–31.CrossRefPubMed

83.

Kim HS, Baik J-H, Pham LD, Jacobs MA. MR-guided high intensity focused ultrasound treatment for symptomatic uterine leiomyomata: long-term outcomes. Acad Radiol. 2011;. doi:10.1016/j.acra.2011.03.008.

84.

Kim Y-S, Kim J-H, Rhim H, Lim HK, Keserci B, Bae D-S, et al. Volumetric Mr-guided high-intensity focused ultrasound ablation with a one-layer strategy to treat large uterine fibroids: initial clinical outcomes. Radiology. 2012;263(2):600–9.CrossRefPubMed

85.

Funaki K, Fukunishi H, Sawada K. Clinical outcomes of magnetic resonance-guided focused ultrasound surgery for uterine myomas: 24-month follow-up. Ultrasound Obstet Gynecol. 2009;34:584–9. doi:10.1002/uog.7455.CrossRefPubMed

86.

Clark NA, Mumford SL, Segars JH. Reproductive impact of MRI-guided focused ultrasound surgery for fibroids: systematic review of the evidence. Curr Opin Obstet Gynecol. 2014;26(3):151–61.CrossRefPubMedPubMedCentral

87.

Zaher S, Lyons D, Regan L. Successful in vitro fertilization pregnancy following magnetic resonance-guided focused ultrasound surgery for uterine fibroids. J Obstet Gynaecol Res. 2011;37(4):370–3. doi:10.1111/j.1447-0756.2010.01344.x.CrossRefPubMed

88.

BohlmannM K, Hoellen F, Hunold P, David M. High-intensity focused ultrasound ablation of uterine fibroids-potential impact on fertility and pregnancy outcome. Geburtshilfe Frauenheilkd. 2014;74(2):139–45. doi:10.1055/s-0033-1360311.CrossRef

89.

Rabinovici J, David M, Fukunishi H, Morita Y, Gostout BS, Stewart EA. Pregnancy outcome after magnetic resonance–guided focused ultrasound surgery (MRgFUS) for conservative treatment of uterine fibroids. Fertil Steril. 2010;93:199–209.CrossRefPubMed

90.

Clark Natalie A, Mumford Sunni L, Segars James H. Reproductive impact of MRI-guided focused ultrasound surgery for fibroids: a systematic review of the evidence. Curr Opin Obstet Gynecol. 2014;26(3):151–61. doi:10.1097/GCO.0000000000000070.CrossRefPubMedPubMedCentral

91.

Ravina JH, Vigneron NC, Aymard A, Le Dref O, Merland JJ. Pregnancy after embolization of uterine myoma: report of 12 cases. Fertil Steril. 2000;73:1241–3.CrossRefPubMed

92.

Pron G, Mocarski E, Bennett J, Vilos G, Common A, Vanderburgh L. Pregnancy after uterine artery embolization for leiomyomata: the Ontario multicenter trial. Obstet Gynecol. 2005;105:67–76.CrossRefPubMed

93.

Walker WJ, McDowell SJ. Pregnancy after uterine artery embolization for leiomyomata: a series of 56 completed pregnancies. Am J Obstet Gynecol. 2006;195:1266–71.CrossRefPubMed

94.

Bonduki CE, Feldner PC Jr, Silva J, Castro RA, Sartori MGF, Girão MJBC. Pregnancy after uterine arterial embolization. Clinics. 2011;66(5):807-10.CrossRefPubMedPubMedCentral

95.

Leung JH, Yu SC, Cheung EC, Wong AS, Tong MM, Ho SS, Leung VY, Ahuja AT. Safety and efficacy of sonographically guided high-intensity focused ultrasound for symptomatic uterine fibroids. J Ultrasound Med. 2014;33(10):1811–8. doi:10.7863/ultra.33.10.1811.CrossRefPubMed

96.

Rabinovici J, Inbar Y, Revel A, Zalel Y, Gomori JM, Itzchak Y, et al. Clinical improvement and shrinkage of uterine fibroids after thermal ablation by magnetic resonance-guided focused ultrasound surgery. Ultrasound Obstet Gynecol. 2007;30:771–7.CrossRefPubMed

97.

Quinn SD, Vedelago J, Gedroyc W, Regan L. Safety and five-year re-intervention following magnetic resonance-guided focused ultrasound (MRgFUS) for uterine fibroids. Eur J Obstet Gynecol Reprod Biol. 2014;182:247–51.CrossRefPubMed

98.

Gizzo S, Saccardi C, Patrelli TS, Ancona E, Noventa M, Fagherazzi S, Mozzanega B, D’Antona D, Nardelli GB. Magnetic resonance-guided focused ultrasound myomectomy: safety, efficacy, subsequent fertility and quality-of-life improvements, a systematic review. Reprod Sci. 2014;21(4):465–76.CrossRefPubMed

Title: Uterine fibroid therapy using interventional radiology mini-invasive treatments: current perspective
Authors: Carlo Masciocchi
Francesco Arrigoni
Fabiana Ferrari
Aldo Victor Giordano
Sonia Iafrate
Ilaria Capretti
Ester Cannizzaro
Alfonso Reginelli
Anna Maria Ierardi
Chiara Floridi
Alessio Salvatore Angileri
Luca Brunese
Antonio Barile
Publication date: 01-04-2017
Publisher: Springer US
Published in: Medical Oncology / Issue 4/2017
Print ISSN: 1357-0560
Electronic ISSN: 1559-131X
DOI: https://doi.org/10.1007/s12032-017-0906-5

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Obesity Clinical Trial Summary

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A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

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Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits

Illustration of figure on mountain summit/© Orapun / Stock.adobe.com, STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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Other articles of this Issue 4/2017

Clinical value of monoclonal antibodies and tyrosine kinase inhibitors in the treatment of head and neck squamous cell carcinoma

Safety of herbal medicine use during chemotherapy in patients with ovarian cancer: a “bedside-to-bench” approach

The use of rapid and cost-effective blood-based biomarkers in combination with tumour TNM stage for individual head and neck cancer patient treatment selection

Primary central nervous system lymphoma: essential points in diagnosis and management

New concepts in embolotherapy of HCC

Association between a cardiovascular disease risk assessment and the molecular response to tyrosine kinase inhibitors in chronic-phase chronic myeloid leukemia patients

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

Highlights from the ACC 2024 Congress

ACC 2024 Congress Coverage