Abstracts from Women's Health 2012: The 20th Annual CongressMarch 16–18, 2012 Washington, DC

Background:\udUterine fibroids, found in 20–35% of women over\udthe age of 35, are symptomatic in one-third. From 20 to 50% of\udcases symptoms are severe enough to justify a treatment. Surgery\udis the most employed management, with severe morbidity ac-\udcounting for 3%. Additional semi-invasive approaches were in-\udtroduced. Magnetic Resonance-guided Focus Ultrasound\udSurgery ( MRgFUS) was presented as a new totally non-invasive\udleiomyomas thermal ablation.\udObjectives:\udEvaluate eligibility, feasibility and outcomes of\udMagnetic Resonance-guided Focused Ultrasound Surgery\ud( MRgFUS) and find predictive indexes for treatment success.\udMethods:\udSingle-centre prospective pilot study to evaluate\udMRgFUS for subserosal/intramural uterine leiomyomas. Post-\udtreatment leiomyomas’ volume reduction and symptoms im-\udprovement were assessed, with a 3 months apart follow-up.\udResults:\ud102 pre-menopausal women with symptomatic uter-\udine leiomyomas were screened in the Gynaecology and Radi-\udology Departments of ‘‘Sapienza’’ University of Rome (August\ud2010-August 2011). Eligible patients were 36 (35%); 24 women23%) performed MRgFUS, 12 refused. Three patients (12%)\udunderwent surgical myomectomy for severe pelvic pain and\udmeno-menometrorrhagia within one month from MRgFUS. For\ud20 patients, symptomatology decreased of 30% after 3 months,\udaccording to Symptom Severity Score (SSS) values (p\ud<\ud0.01).\udMean volume change ratio was significant (p\ud<\ud0.01) at 6 months,\udwith 27% of reduction, reaching 47% at 12 months. Feasibility\udrate was 35%. A Vascularity Index\ud<\ud1 showed significant posi-\udtive difference with symptoms improvement (p-value 0,04), with\uda decrease of 32% (23% for VI\ud>\ud1, SSS). Fibroids\ud£\ud70 mm of\uddiameter showed a significant (p-value\ud<\ud0,05) volume reduction\ud(\ud-\ud21%) if compared to greater ones (\ud-\ud14%).\udConclusions:\udMost women with leiomyomas are unsuitable\udfor MRgFUS (anatomical limits and urgent fertility desire). In\udeligible patients, rapid symptom reduction rates were obtained;\udotherwise, volume reduction ratio is slower and incomplete.\udVascularity Index (VI) and fibroids’ size (\ud£\ud70 mm) could be used\udas predictive indexes. An accurate patient selection is needed for\udhigher success and lower re-intervention rates