Ultrasound-guided percutaneous microwave ablation for symptomatic uterine fibroid treatment - A clinical study

Objective: The aim of this study was to assess the feasibility, safety and therapeutic effects of ultrasound (US)-guided percutaneous microwave thermal ablation (PMTA) in situ for the treatment of symptomatic uterine fibroid. Materials and methods: The microwave (MW) antenna was percutaneously inserted into the fibroid under US guidance to perform the ablation. The ultrasound images, any complications and side effects were assessed during and after ablation. The shrinkage rate of the fibroid was calculated after the treatment. Results: Forty patients underwent the treatment. The baseline fibroid volume was 14.6 to 341.1 cm(3) (mean 140.1 +/- 87.4 cm(3)). When the MW therapy started, a heightened echo around the MW emission aperture of the antenna was observed and gradually propagated throughout the fibroid while the ablation continued. The mean ablation time was 490 s. Contrast enhanced MRI showed no enhancement in the fibroid post-ablation. The shrinkage rate of the fibroid was 61.8%, 78.7%, 73.2% and 93.1% at 3, 6, 9, and 12 months after ablation, respectively. Six patients felt pain in their lower abdomens or waists within 12 hours post-ablation, and the discomfort rapidly disappeared. Seven patients had a small amount of vaginal bloody secretions within one to two weeks after treatment, and six of these patients recovered from the bleeding without any therapy after one week. No patient developed complications and fever during or after the ablation. Conclusions: PMTA for fibroid is feasible and safe, and it is an easy and fast procedure that is minimally invasive.