Table 6: Factors weighing in on the selection process of patients for MRgFUS procedure.
Factors | Treatment might be helpful without complications | No treatment necessary/Treatment possibly harmful | Possible countermeasures to negative factors | Relative numbers [116,120] |
Symptoms relevance | Significant symptoms | No significant symptoms | Preventive treatment | - |
Fibroid type | Any non-pedunculated | Pedunculated | Release of fibroid into abdominal cavity never documented | 5/373 (1.34%) Overall: 1-5% |
Fibroid size | 3-10 cm | < 3 cm; > 10 cm/> 300 ml | Multiple treatments, GnRHa | 20/373 (5.36%) Overall: 5-11% |
Distance from skin | Inside available treatment area | > 50% outside of possible treatment area | Thin gel pad; rectal filling | 2/373 (0.53%) |
Fibroid number | ≤ 6 | > 6 fibroids | - | 45/373 (12.06%) |
Distance from Bones | - | Close to vertebrae or sacrum | Tilting beam path; rectal filling; multiple, smaller treatments | - |
Obstacles along US beam path | None | Scars, bone, air, bowel | Rectal/bladder fill, beam angulation | 2/169 (1.18%) |
Fibroid vascularity | Little vascularity | Increased vascularity | GnRHa | - |
Beam aberration | - | Tissue irregularities along the beam path | - | - |
Adenomyosis | - | Presence of adenomyosis | Possibly treatment | 16/373 (4.29%) |
Malignancy | - | Presence of malignancy | Surgical intervention | 19/373 (4.29%) |
GnRHa: Gonadotropin Releasing Hormone analog; US: Ultrasound.