Interventional magnetic resonance imaging cryotherapy of uterine fibroid tumors: Preliminary observation

Objective: The purpose of this study was to identify alternatives to hysterectomy. We have developed a transabdominal interventional magnetic resonance imaging-guided cryoablation procedure and report this novel approach. Study Design: This represents the preliminary and first report of a prospective Institutional Review Board-approved protocol to study interventional magnetic resonance imaging-guided cryoablation of uterine fibroid tumors. Women were selected on the basis of symptoms that were related to uterine fibroid tumors (bleeding, uterine pain, pelvic congestion, compression symptoms) and the absence of any desire for child bearing. A physical examination confirmed the presence of fibroid tumors, and magnetic resonance imaging was performed before the procedure to measure the size and number of fibroid tumors. Patients returned to the interventional magnetic resonance imaging and underwent placement of 3 to 5 probes (2-3 mm) under magnetic resonance imaging-directed guidance. Follow-up magnetic resonance imaging determined the size reduction of the lesion, and a clinical evaluation determined the change in symptoms. Results: Nine patients were treated and had substantial reduction in the uterine size (average, 66% volume reduction), and their primary symptoms have either improved or resolved. Conclusion: This is the first reported review of interventional magnetic resonance imaging-directed cryotherapy of uterine fibroid tumors. This minimally invasive therapy produced shrinkage of the tumor in 8 of our first 9 patients. (Am J Obstet Gynecol 2002;186:1183-7.)