Sound over scalpel
Dr. Elizabeth David, an affiliate scientist in the Odette Cancer Research Program at Sunnybrook Research Institute (SRI), describes the early results of a clinical trial examining a new nonsurgical approach to treat uterine fibroids. The technique, called magnetic resonance imaging (MRI)-guided focused ultrasound, was developed by Dr. Kullervo Hynynen, director of Physical Sciences and a world leader in focused ultrasound research.
For further questions about this trial, please feel free to email: hifu.fibroids@sunnybrook.ca
An estimated 20% to 25% of women over age 30 have uterine fibroids, noncancerous tumours that grow on the wall of the uterus. Women with large fibroids can experience heavy bleeding, pelvic pain and bloating. The standard therapy to treat uterine fibroids is a hysterectomy to remove the uterus, which carries a risk of complications, involves a long recovery and removes a woman’s capacity to give birth.
In MRI-guided focused ultrasound, MRI is used to locate the fibroids, which are subsequently targeted by high-intensity ultrasound waves to burn away the blood vessels feeding the tumour. The technique is noninvasive, painless and has a much shorter recovery time: patients often return to their normal activities, like work, the next day. It also preserves fertility.
Building on preclinical studies by Hynynen and his team, David, who is also an interventional radiologist, is leading a double-blind, randomized controlled trial to test the efficacy of MRI-guided focused ultrasound to relieve fibroid symptoms in patients. The study began in 2012 and is scheduled to be completed in 2019.
While the treatment does not eliminate fibroids completely, early results from the trial indicate that it shrinks the tumours by 20% to 50%. Further, up to 90% of women receiving the treatment report being symptom-free soon after. The technique was recently evaluated by Health Quality Ontario as being an effective and cost-saving intervention. The agency is recommending the widespread use of focused ultrasound as a noninvasive option for women with uterine fibroids who want to avoid a hysterectomy.
