The safety and efficacy of MR-guided focused ultrasound surgery in the treatment of pedunculated subserosal myomas of the uterus: preliminary report

Purpose: To evaluate the safety and efficacy of MR-guided focused ultrasound surgery (MRgFUS) in treating pedunculated subserosal myoma of the uterus.

Methods and materials: Over a one-year period, 113 women were treated with MRgFUS for symptomatic uterine myomas. Myomas were confirmed by MR imaging prior to treatment. Among the 113 women, six women (age range, 33–47, mean age, 39.5 years) had pedunculated subserosal myomas (myoma in which diameter of the stalk was 50% narrower than the diameter of the myoma) of the uterus. The nonperfused volume (NPV) within these pedunculated subserosal myomas was determined at the time of treatment, and volume change and shape of the treated myomas were evaluated three to six months after treatment.

Results: The volume of the treated myomas ranged from 80 cc to 380 cc (mean 239 cc). NPV ranged from 45% to 75% (mean NPV, 63%). On follow-up MRI three months after treatment, a 14–38% (mean 23%) reduction in the volume of treated myomas was observed. In all cases, the pedunculated myoma remained connected to the uterus. The majority of patients (83%) experienced improvement of bulk-related myoma symptoms after treatment.

Conclusion: Pedunculated subserosal myomas of the uterus can be treated safely and effectively with MRgFUS.