Efficacy of single-dose gonadotropin-releasing hormone agonist administration prior to magnetic resonance-guided focused ultrasound surgery for symptomatic uterine fibroids.

PURPOSE: To investigate the effects of a single-dose GnRHa on the thermal ablation of MRgFUS in women with symptomatic fibroids.

MATERIALS AND METHOD: In this pilot study, a single-dose GnRHa was administered in 17 patients with a total of 20 fibroids. Volume and scaled signal intensity (SSI) as an objective marker of fluid contents were prospectively followed up with serial MR scans. The control group of 17 patients with 19 fibroids were retrospectively enrolled and compared with GnRHa group in terms of non-perfused volume (NPV) and thermal dosimetry to assess the efficiency of thermal ablation.

RESULTS

About 29 days after GnRHa administration, SSI and volume of fibroids were reduced by 55.1 and 10.6%, respectively (p < 0.05) but no adverse events were reported. NPV per unit energy (0.046 cm3/J ± 0.026 vs. 0.031 cm3/J ± 0.018, p = 0.041) was larger and SSI (8.4 ± 8.0 vs. 13.9 ± 12.0, p = 0.053) was lower in GnRHa group. Linear regression analysis showed that these two parameters were in a reverse correlation (p = 0.011).

CONCLUSION

GnRHa is supposed to reduce the fluid contents of fibroids including blood vessels and enhance the tissue responsiveness to thermal energy. A single dose prior to MRgFUS has the potential to improve treatment efficiency, while avoiding the side effects of multiple doses of GnRHa.