Uterine Fibroid Treatment Points to New Direction in MRI Use

(HealthDay News) – If the digital camera has caused a revolution in how people take photos and send them to friends and family, the magnetic resonance imaging device (MRI) has done the same thing for the medical professional.

The MRIs has become the “medical assistant” for everything from detecting possible breast malignancies to helping locate tumors in the colon. The device works through using powerful magnets and radio waves.

According to the U.S. government’s National Library of Medicine, the magnetic field produced by an MRI scanner “forces hydrogen atoms in the body to line up in a certain way (similar to how the needle on a compass moves when you hold it near a magnet).

“When radio waves are sent toward the lined-up hydrogen atoms, they bounce back, and a computer records the signal. Different types of tissues send back different signals. For example, healthy tissue sends back a slightly different signal than cancerous tissue,” the National Library of Medicine says.

The magnetic field produced by an MRI is 10,000 greater the magnetic field created by the earth, so its possible uses are still in their infancy.

One recent example of MRI effectiveness was developed in England, where the new method used the MRI to guide lasers in destroying fibroid tumors and required only a local anesthetic.

Although lasers have been used to treat fibroids, the affair was notoriously hit-or-miss, and often caused damage to surrounding tissue, says Dr. Wladyslaw Gedroyc, a consultant radiologist and head of the Department of Interventional Magnetic Resonance Imaging at St. Mary's Hospital in London. Gedroyc led the study in using the MRI for the procedure, which resulted in an article for the journal Human Reproduction.

"Before, you had absolutely no control over what you were doing," Gedroyc says, “but MRI lets physicians use lasers with much more precision.”

It’s estimated that about 25 percent of women suffer from fibroids, which are benign fibrous tumors in the uterus. Some are asymptomatic, but others can cause excessive bleeding and pain, and may result in infertility or miscarriage. When symptoms are problematic, a major recourse has been to remove the uterus with a hysterectomy, a major surgery that many experts feel is excessive.

Less invasive techniques are being developed, but most still require general anesthetic and a hospital stay, the study authors say.

In the MRI procedure, which was performed on 66 women between the ages of 34 and 55, the surgeon -- using the MRI as a guide -- inserted four small needles into the fibroid. Laser fibers inserted into the needles destroyed the fibroid with heat. The image turned from blue to green when the temperature reaches the right level, so the doctor knew when to "maximize treatment" in the target area.

The women who had the procedure experienced a mean reduction in fibroid volume of 31 percent after three months, with the range being 13 percent to 78 percent. The 24 women who received one-year follow-up MRI scans had a mean reduction of 41 percent. All but one of the patients had the procedure done on an outpatient basis.

A minority of the women in the study were surveyed for blood loss after the procedure, and all of them reported less blood loss three months later. Of 35 women who completed a survey, 69 percent reported an improvement in symptoms.

Some physicians say the procedure doesn't address the right issues, however.

"They're not addressing the reasons for the condition in the first place," says Dr. Allan Warshowsky, author of Healing Fibroids: A Doctor's Guide to a Natural Cure and director of the Women's Center at the Continuum Center for Health and Healing in New York City.

There are also various limitations, Warshowsky points out, including where the fibroid is located and how large the woman is. "They can't do this through the abdomen in fibroids that are way posterior," Warshowsky says. "Accessibility is probably also related to the woman's abdominal girth."

Because estrogen tends to fuel fibroids, and because fat increases estrogen production, overweight women tend to be particularly prone to fibroids.

On the Web

The U.S. government’s a women’s Internet site, womem.gov, has a whole section dedicated to detection and treatment of uterine fibroids.

SOURCES: Wladyslaw Gedroyc, M.D., radiologist and director of the interventional MRI group, Department of Radiology, St. Mary’s Hospital, London; Allan Warshowsky, M.D., director, Women's Program, Continuum Center for Health and Healing, New York City; October 2002 Human Reproduction
Publication date: May 1, 2007
Author: Amanda Gardner, HealthDay Reporter
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