CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2012; 22(02): 93-97
DOI: 10.4103/0971-3026.101078
Interventional Radiology

Noninvasive treatment of focal adenomyosis with MR-guided focused ultrasound in two patients

Laveena Polina
Department of Radiology, Godavari Imaging Sciences and Research Center, Rajahmundry, Andhra Pradesh, India
,
Vinay Nyapathy
Department of Radiology, Godavari Imaging Sciences and Research Center, Rajahmundry, Andhra Pradesh; Department of Radiology, GSL Medical College, Rajahmundry, Andhra Pradesh, India
,
Anindita Mishra
Department of Radiology, GSL Medical College, Rajahmundry, Andhra Pradesh, India
,
Himabindu Yellamanthili
Department of Obstetrics and Gynaecology, GSL Medical College, Rajahmundry, Andhra Pradesh, India
,
Mythri P Vallabhaneni
Department of Radiology, GSL Medical College, Rajahmundry, Andhra Pradesh, India
› Author Affiliations
Financial support and sponsorship Nil.

Abstract

Adenomyosis is a common benign gynecological disorder presenting with dysmenorrhea, menorrhagia, and pressure symptoms. Magnetic resonance imaging-guided focused ultrasound surgery (MRgFUS) utilizes precisely focused USG waves to generate and maintain high temperatures within the targeted tissue to achieve protein denaturation and coagulative necrosis. The heat generated is monitored using MRI images acquired in real-time in three planes. We present two cases of focal adenomyosis treated with MRgFUS showing good symptomatic relief at 3 and 6 months follow-up.



Publication History

Article published online:
30 July 2021

© 2012. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 
  • References

  • 1 Ota H, Igarashi S, Hatazawa J, Tanaka T. Is adenomyosis an immune disease? Hum Reprod Update 1998;4:360-7.
  • 2 Stewart EA, Gostout B, Rabinovici J, Kim HS, Regan L, Tempany CMC. Sustained relief of leiomyoma symptoms by using focused ultrasound surgery. Obstet Gynecol 2007;110:279-87.
  • 3 Fukunishi H, Funaki K, Sawada K, Yamaguchi K, Maeda T, Kaji Y. Early results of magnetic resonance-guided focused ultrasound surgery of adenomyosis : Analysis of 20 cases. J Minim Invasive Gynecol 2008;15:571-9.
  • 4 Yoon SW, Kim KA, Cha SH, Kim YM, Lee C, Na YJ, et al. Successful use of magnetic resonance-guided focused ultrasound surgery to relieve symptoms in a patient with symptomatic focal adenomyosis. Fertil Steril 2008;90:2018. e13-5.
  • 5 Spies JB, Coyne K, Guaou Guaou N, Boyle D, Skyrnarz-Murphy K, Gonzalves SM. The UFS-QOL, a new disease-specific symptom and health-related quality of life questionnaire for leiomyomata. Obstet Gynecol 2002;99:290-300.
  • 6 Tamai K, Togashi K, Ito T, Morisawa N, Fujiwara T, Koyama T. MR imaging findings of adenomyosis: Correlation with histopathologic features and diagnostic pitfalls. Radiographics 2005;25:21-40.
  • 7 Ascher SM, Jha RC, Reinhold C. Benign myometrial conditions : Leiomyomas and adenomyosis. Top Magn Reson Imaging 2003;14:281-304.
  • 8 Bragheto AM, Caserta N, Bahamondes L, Petta CA. Effectiveness of the levonorgestrel-releasing intrauterine system in the treatment of adenomyosis diagnosed and monitored by magnetic resonance imaging. Contraception 2007;76:195-9.
  • 9 Freundl G, Gödtke K, Gnoth C, Godehardt E, Kienle E. Steroidal ′add-back′ therapy in patients treated with GnRH agonists. Gynecol Obstet Invest 1998;45 Suppl 1:22-30; discussion 35.
  • 10 Imaoka I, Ascher SM, Sugimura K, Takahashi K, Li H, Cuomo F, et al. MR imaging of diffuse adenomyosis changes after GnRH analog therapy. J Magn Reson Imaging 2002;15:285-90.
  • 11 Igarashi M. A new therapy for pelvic endometriosis and uterine adenomyosis : Local effect of vaginal and intrauterine danazol application. Asia Oceania J Obstet Gynaecol 1990;16:1-12.
  • 12 McCausland AM, McCausland VM. Depth of endometrial penetration in adenomyosis helps determine outcome of rollerball ablation. Am J Obstet Gynecol 1996;174:1786-93.
  • 13 Kanaoka Y, Hirai K, Ishiko O. Successful microwave endometrial ablation in a uterus enlarged by adenomyosis. Osaka City Med J 2004;50:47-51.
  • 14 Smith SJ, Sewall LE, Handelsman A. A clinical failure of uterine fibroid embolization due to adenomyosis. J Vasc Interv Radiol 1999;10:1171-4.
  • 15 Pelage JP, Jacob D, Fazel A, Namur J, Laurent A, Rymer R, et al. Midterm results of uterine artery embolization for symptomatic adenomyosis: Initial experience. Radiology 2005;234:948-53.
  • 16 Lohle PN, De Vries J, Klazen CA, Boekkooi PF, Vervest HA, Smeets AJ, et al. Uterine artery embolization for symptomatic adenomyosis with or without uterine leiomyomas with the use of calibrated tris-acryl gelatin microspheres : m0 idterm clinical and MR imaging follow-up. J Vasc Interv Radiol 2007;18:835-41.
  • 17 Levgur M. Therapeutic options for adenomyosis : a0 review. Arch Gynecol Obstet 2007;276:1-15.
  • 18 Hindley J, Gedroyc WM, Regan L, Stewart E, Tempany C, Hynyen K, et al. MRI guidance of focused ultrasound therapy of uterine fibroids : e0 arly results. AJR Am J Roentgenol 2004;183:1713-9.
  • 19 Morita Y, Ito N, Hikida H, Takeuchi S, Nakamura K, Ohashi H. Non-invasive magnetic resonance imaging-guided focused ultrasound treatment for uterine fibroids - early experience. Eur J Obstet Gynecol Reprod Biol 2008;139:199-203.
  • 20 Rabinovici J, Inbar Y, Eylon SC, Schiff E, Hananel A, Freundlich D. Pregnancy and live birth after focused ultrasound surgery for symptomatic focal adenomyosis : A case report. Hum Reprod 2006;21:1255-9.
  • 21 Fennessy FM, Tempany CM. A review of magnetic resonance imaging-guided focused ultrasound surgery of uterine fibroids. Top Magn Reson Imaging 2006;17:173-9.
  • 22 Funaki K, Fukunishi H, Funaki T, Sawada K, Kaji Y, Maruo T. Magnetic resonance-guided focused ultrasound surgery for uterine fibroids : Relationship between the therapeutic effects and signal intensity of preexisting T2-weighted magnetic resonance images. Am J Obstet Gynecol 2007;196:184.e1-6.
  • 23 Kim KA, Yoon SW, Lee C, Seong SJ, Yoon BS, Park H. Short-term results of magnetic resonance imaging-guided focused ultrasound surgery for patients with adenomyosis : Symptomatic relief and pain reduction. Fertil Steril 2011;95:1152-5.
  • 24 Gavrilova-Jordan LP, Rose CH, Traynor KD, Brost BC, Gostout BS. Successful term pregnancy following MR-guided focused ultrasound treatment of uterine leiomyoma. J Perinatol 2007;27:59-61.
  • 25 Hanstede MM, Tempany CM, Stewart EA. Focused ultrasound surgery of intramural leiomyomas may facilitate fertility : A case report. Fertil Steril 2007;88:497.e5-7.
  • 26 Morita Y, Ito N, Ohashi H. Pregnancy following MR-guided focused ultrasound surgery for a uterine fibroid. Int J Gynaecol Obstet 2007;99:56-7.