Evaluation with real-time tissue elastography (rte) of single and multiple fibroids in patients that underwent magnetic resonance-guided focused ultrasound (mrgfus) treatment

Backround: patients affected by single and multiple uterine fibroids and that underwent Magnetic Resonance-Guided Focused Ultrasound (MRgFUS) treatment have been monitored in the post treatment phase with Real-time Tissue Elastography (RTE) in order to evaluate the flexibility and vascularization levels of MRgFUS treated fibroids. Methods: from September 2015 to October 2016, 30 patients aged between 23 and 51 affected by single and multiple uterine fibroids (sized between 2 and 14 cm) have been monitored in our clinic unit through the Real-time Tissue Elastography (RTE) to examine the flexibility level of MRgFUS treated fibroids. Results: In our operating unit, 30 patients out of 30 have undergone the evaluation through elastosonography before and after the Magnetic Resonance-Guided Focused Ultrasound (MRgFUS) treatment for single and multiple uterine fibroids. Beyond the elastosonography evaluation, patients have been closely evaluated by means of a complete gynecological examination, a transvaginal ultrasound, an MRI with and without contrast agent and a symptoms severity score (SSS) questionnaire. All the evaluations have been carried out for the selection of patients that had to undergo the focused ultrasound treatment and, after the treatment, a 3 months, 6 months and 9 months follow-up. 29 patients out of 30 had, after 12 months, a 75% reduction of the NVP, an 80% reduction of the SSS and a 70% reduction in average of the fibroid volume. With the use of elastosonography, the level of elasticity and vascularisation of the treated area has been highlighted. Conclusions: elastosonography represents a diagnostic instrument in addition to the gynecological examination, the transvaginal ultrasound, the MRI with and without contrast agent and the symptoms severity score (SSS) questionnaire, in order to evaluate the effectiveness of focused ultrasound in the treatment of single and multiple uterine fibroids in women of childbearing age and not. Furthermore, it represents an extra tool in the evaluation of patients to be included in the focused ultrasound treatment and to evaluate the rigidity level of the fibroid after the treatment.