UCSF Offers an Innovative, Non-Invasive Treatment for Uterine Fibroids

The following was written by Maureen Kohi, M.D., an Assistant Professor of Clinical Radiology in the Department of Radiology and Biomedical Imaging at UCSF.

UCSF now offers an innovative technique for uterine fibroid treatment: Magnetic Resonance-guided Focused Ultrasound, also called MR-guided Focused Ultrasound or MRgFUS. This FDA-approved procedure treats uterine fibroids, relieving heavy menstrual bleeding, pelvic pressure, and other fibroid symptoms. Also known as High Intensity Focused Ultrasound or HIFU, it preserves the uterus without open surgery or laparoscopic surgery, and it may help women avoid invasive surgeries such as hysterectomy or myomectomy.

As described in a recent San Francisco Chronicle article, MRgFUS is a completely non-invasive procedure in which sound waves pass through the lower abdomen and converge in an area the size of a grain of rice within the fibroid.  The focused ultrasound waves create heat that destroys the fibroid cells without impacting the surrounding healthy tissue.  Although the procedure can take up to five hours to complete, women leave the hospital the same day and are back to normal activities in a few days.

UCSF is the only fibroid treatment center on the entire West Coast to be involved in a prospective randomized clinical trial sponsored by the NIH that studies women undergoing MRgFUS and compares them to women undergoing uterine artery embolization (another treatment for symptomatic fibroids).  Most patients report  improvement in their symptoms within three months of the procedure.  More than 70 percent of women experience significant improvement in the severity of their fibroid-related symptoms within the first six months after MRgFUS.  Women report relief from their fibroid symptoms for up to 24 months—the longest follow-up period to date.

In addition to myself (an interventional radiologist who performs the treatments), our MR-guided Focused Ultrasound team consists of a nurse, technologist and physicist, and we are all very experienced in this procedure.

To be considered for MRgFUS, a patient must meet the following screening criteria:

·         Be age 18 or older.
·         Have symptoms of fibroids in the uterus.
·         Have one or more uterine fibroids that are positioned in the uterus such that they can be accessed without being shielded by the bowel or bone.
·         Have a fibroid with appropriate characteristics (e.g., size and density).
·         Be pre- or peri-menopausal (within 12 months of last menstrual period).
·         Not be seeking treatment to improve fertility.

A pelvic MRI scan must be performed before treatment to determine whether the patient is a good candidate for MRgFUS.  While it is not necessary for the patient to have her MRI at UCSF, if she has the MRI at a facility other than UCSF, she risks having the MRI performed below the required standards for focused ultrasound surgery. Having the MRI at UCSF also ensures faster results to determine her candidacy for the procedure.

UCSF's Radiology Billing & Insurance Department routinely contacts patients’ insurance companies to get authorization to cover procedures like this.  In cases where the insurance is not authorized, the patient will still have the option of a discounted self-pay price.

UCSF is participating with Mayo Clinic and Duke University in a study to compare uterine artery embolization and MRgFUS for the treatment of uterine fibroids.  The study, called Fibroid Interventions: Reducing Symptoms Today and Tomorrow (FIRSTT), will follow patients after treatment to assess how effective the treatments are in symptom relief, absence of side effects, impact on quality of life, need for additional treatment, and the costs associated with each approach.  We are currently seeking candidates for this study, which is funded by the National Institutes of Health.  To be eligible to be included in the study a woman must be premenopausal, at least 25 years of age, and willing to be in a randomized trial.  Those interested in participating should call Stephanie Lemp (clinical research coordinator) at (415) 297-3114.

Depending on various factors, women who want more information or who want to schedule a procedure should do the following:

  • If the woman has a personal physician, she should discuss this treatment for uterine fibroids with her gynecologist, obstetrician or primary care physician.
  • If she has no personal physician to provide a referral, the woman may call (415) 885-7788 and press option #1 to make an appointment with Vanessa Jacoby, MD, UCSF’s gynecologist who specializes in fibroid treatments and is knowledgeable about advanced techniques such as MRgFUS.
  • Patients who have a referral from a personal physician for a fibroid treatment procedure may call directly to UCSF’s interventional radiology scheduling department at (415) 353-1300 to make an appointment for an evaluation for a procedure.

In cases where MRgFUS may not be a viable option, uterine artery embolization (UAE), is another nonsurgical fibroid treatment offered by UCSF.  That is one of many care and treatment options for women with uterine fibroids offered at the UCSF Comprehensive Fibroid Center at Mount Zion and Mission Bay.

UCSF now offers an innovative technique for uterine fibroid treatment: Magnetic Resonance-guided Focused Ultrasound, also called MR-guided Focused Ultrasound or MRgFUS.