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Although many women undergo hysterectomy for treatment of uterine fibroids, there are more options than ever before for fibroid treatment. A combination of objective criteria, including clinical parameters, anatomic factors, fibroid characteristics, and patient desires influence the choice of optimal therapeutic modality for a woman with symptomatic uterine fibroids. Magnetic resonance imaging-guided high intensity focused ultrasound (MR-HIFU) is the only noninvasive treatment option for women with symptomatic uterine fibroids unresponsive to medical treatment. The procedure has been shown to be safe and effective. MR-HIFU couples the three-dimensional multiplanar anatomic imaging and thermal monitoring capability of MR imaging with the therapeutic thermal-based coagulative necrosis mechanism of HIFU to safely and effectively ablate limited volume classical fibroids. In the author's experience, a multidisciplinary fibroid clinic facilitates a unified approach between gynecologists, radiologists, and others to individualize the most appropriate fibroid treatment options for each woman. This article describes the MR-HIFU technique and outcomes, as well as patient selection and treatment assessment.

Clinical and Technical Aspects of MR-Guided High Intensity Focused Ultrasound for Treatment of Symptomatic Uterine Fibroids