In vivo feasibility of image-guided transvaginal focused ultrasound therapy for the treatment of intracavitary fibroids

Chan, Arthur H.; Fujimoto, Victor Y.; Moore, Donald E.; Held, Robert T.; Paun, Marla; Vaezy, Shahram

doi:10.1016/j.fertnstert.2004.01.049

« Previous Next »Fertility and Sterility
Volume 82, Issue 3 , Pages 723-730, September 2004

In vivo feasibility of image-guided transvaginal focused ultrasound therapy for the treatment of intracavitary fibroids

Arthur H. Chan, Ph.D.
- Department of Bioengineering, University of Washington, Seattle, Washington, USA
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA
Victor Y. Fujimoto, M.D.
- Department of Obstetrics, Gynecology and Reproductive Services, University of California, San Francisco, California, USA
Donald E. Moore, M.D.
- Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington, USA
Robert T. Held
- Department of Bioengineering, University of Washington, Seattle, Washington, USA
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA
Marla Paun, B.S.
- Department of Bioengineering, University of Washington, Seattle, Washington, USA
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA
Shahram Vaezy, Ph.D.
- Department of Bioengineering, University of Washington, Seattle, Washington, USA
- Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle, Washington, USA
- Reprint requests: Shahram Vaezy, Ph.D., Center for Industrial and Medical Ultrasound Applied Physics Laboratory, University of Washington, Box 355640, 1013 NE 40th St., Seattle, Washington 98105 (FAX: 206-221-6578)

Received 4 September 2003; received in revised form 15 January 2004; accepted 15 January 2004.

Objective

To determine the feasibility of uterine tissue ablation in vivo using a transvaginal focused ultrasound applicator guided by ultrasound imaging.

Design

Randomized in vivo animal study.

Setting

Academic research environment.

Animal(s)

Healthy anesthetized sheep.

Intervention(s)

Uterine treatment location was determined using a computerized targeting system. Five sonications 10 seconds in duration and averaging 2,000 W/cm² of focal ultrasound intensity were applied in each animal's uterus. Animals were euthanized either immediately or 2, 7, or 30 days post-treatment.

Main outcome measure(s)

Gross and microscopic analysis of the dissected uterus was used to quantitatively and qualitatively determine the ablated region and treatment side effects.

Result(s)

Treatments resulted in coagulative necrosis. Histopathological analysis showed that over 7 days, inflammatory cells appeared and smooth muscle bundles regenerated. By day 30, treated tissues healed and scar tissue formed. None of the animals showed abnormal behavior or medical problems. Complications in three animals were damage to the vaginal wall and colon, possibly due to inadequate applicator cooling and an empty bladder during treatment.

Conclusion(s)

Transvaginal image-guided high-intensity focused ultrasound has potential for treating uterine fibroids. Further safety testing of this treatment will prepare it for human use.

Key words: Uterine fibroids , leiomyoma , high-intensity focused ultrasound , image-guided therapy , ultrasound

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Financial support was received from the Whitaker Foundation, the National Institutes of Health, and the Natural Sciences and Engineering Research Council (Canada).

PII: S0015-0282(04)00983-5

doi:10.1016/j.fertnstert.2004.01.049

« Previous Next »Fertility and Sterility
Volume 82, Issue 3 , Pages 723-730, September 2004

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