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Fibroid treatment with MR-guided focused ultrasound (MRgFUS; syn.: HIFU = high-intensity focused ultrasound) is a thermoablative method in which the tissue to be treated is heated by focused ultrasound in single small volume increments (sonifications, syn: sonications) under constant MRI control until complete denaturation of the planned fibroid volume is achieved. After thermoablation, imaging showed a lack of contrast enhancement of the treated tissue (NPV = non-perfused volume). MRgFUS is organ-preserving and noninvasive and can be performed on an outpatient basis. The treatment method is offered only by a few specialized centers. The goal of MRgFUS treatment is to reduce or eliminate fibroid-related symptoms in affected women. A reduction in fibroid size can be achieved with ultrasound treatment. Complete fibroid regression is not to be expected and is also not the goal of the treatment. The disciplines of gynecology and radiology agree that the indication for the treatment of uterine fibroids should be determined by a gynecologist following examination and counseling of the patient. Comprehensive patient counseling regarding the treatment options in symptomatic uterine fibroids should include medication, surgery, and the two non-surgical treatment options uterine artery embolization (UAE) and MRgFUS. The decision for or against a treatment alternative should be made under consideration of the patient's wishes and with knowledge of other treatment options, the chance of success, limitations, typical side effects, and possible complications (informed consent). MRgFUS treatment provides a treatment method for patients with fibroid-related symptoms and allows further treatment individualization for uterine fibroids in Germany, Austria, and Switzerland.

MR-Guided Focused Ultrasound in Fibroid Treatment – Results of the 3rd Radiological-Gynecological Expert Meeting