Patient Guide for the MRgFUS Procedure

MRgFUS Abdominal pain

MR-guided focused ultrasound treament (MRgFUS) is performed as an outpatient procedure, and patients remain conscious but sedated so as to feel minimal abdominal pain. It does not require general anesthesia, and recovery time is also significantly reduced compared to surgical alternatives for treating fibroids.

(Image on the right:  Patient situated comfortably by Dr. Maureen Kohi, prior to MR-guided focused ultrasound treatment.)

Before the procedure

Several tests and discussions are required before performing a MRgFUS procedure, to make sure that only appropriate patients (those likely to benefit from the procedure and without risk factors that would be a contra-indication to performing the procedure) are selected. Women having an MRgFUS to treat one or more uterine fibroids must be seen by a gynecologist and have an MRI exam.  If it is determined that the woman is a candidate for MRgFUS, then she must be seen by the UCSF interventional radiologist who will perform the procedure.

During the procedure

The length of the procedure is variable, but most cases last at least three hours.  The patient lies on her stomach within the MRI scanner. Mild sedation and pain medicine are used to reduce discomfort and anxiety during the procedure.  The patient remains conscious and is able to communicate throughout the treatment. Initial images are obtained to confirm the target is still accessible and appropriate. Then separate pulses of focused ultrasound energy are applied through the skin using a transducer.  Each pulse (called a “sonication”) lasts about 20 seconds and is used to destroy the fibroid in a piece by piece fashion. It is normal for the patient to feel a warming sensation during the sonications. Patients are given a safety stop button that allows them to immediately stop the sonication in the unlikely event that the treatment becomes painful. At the end of the procedure the patient receives an injection of an MRI contrast dye (“gadolinium”) to confirm that the target fibroid(s) have been successfully treated.

After the procedure

After MRgFUS, patients are allowed to rest comfortably while the effects of any medication given are allowed to wear off.  Occasionally, patients may experience some abdominal pain or discomfort or menstrual-like cramping.  Patients are encouraged to take over-the-counter pain relief medication if uncomfortable.  Most women are able to return to work within a few days.

The positive results of the MR-guided focused ultrasound procedure typically are experienced within the first menstrual cycle or within a month.  Many women have a continuing decrease in the symptoms of the fibroids in months two through six.