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J Ther UltrasoundJ Ther UltrasoundJournal of Therapeutic Ultrasound2050-5736BioMed Central 2050-5736-3-S1-O9210.1186/2050-5736-3-S1-O92Oral PresentationVolumetric MR-guided high-intensity focused ultrasound with direct skin cooling for the treatment of symptomatic uterine fibroids: proof of concept study Ikink Marlijne 1van Breugel Johanna 1Schubert Gerald 2Nijenhuis Robbert 1Bartels Lambertus W  1Moonen Chrit 1van den Bosch Maurice 11 University Medical Center Utrecht, Utrecht, Netherlands2 Philips Healthcare, Vantaa, Finland2015 30 6 2015 3 Suppl 1 Current and Future Applications of Focused Ultrasound 2014. 4th International Symposium: abstractsPublication of this supplement was funded by the Focused Ultrasound Foundation.O92 O92 Copyright © 2015 Ikink et al; licensee BioMed Central Ltd.2015Ikink et al; licensee BioMed Central Ltd.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.12-16 October 2014 Current and Future Applications of Focused Ultrasound 2014. 4th International Symposium Washington, D.C, USA
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Background/introduction
To prospectively assess the safety and technical feasibility of volumetric magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) ablation with direct skin cooling (DISC) during treatment of uterine fibroids.

Methods
In this proof-of-concept study, eight patients were selected for clinical MR-HIFU ablation of uterine fibroids with use of an additional DISC device to maintain a constant temperature (T≈20°C) at the interface between the HIFU table-top and the patients' skin (Figure 1). Technical feasibility was determined by verification of successful completion of MR-HIFU ablation. Contrast-enhanced T1-weighted MRI was used to measure the treatment effect (non-perfused volume (NPV) ratio). Safety was evaluated by recording of adverse events (AEs) and their relation to the investigational DISC device within 30 days' follow-up.

Figure 1 Results and conclusions
Results: All MR-HIFU treatments were successfully completed in an outpatient setting. The median NPV-ratio was 0.56 (IQR[0.27-0.72]). Immediately after treatment, two patients experienced coldness related discomfort which resolved the same day. No serious AEs were reported within 30-days' follow-up. No skin burns, cold injuries or subcutaneous edema were observed in patients treated with the DISC device. Conclusion: This study showed that it is technically feasible and safe to complete a volumetric MR-HIFU ablation with DISC. This technique may further reduce the risk of thermal injury to the abdominal wall during MR-HIFU ablation of uterine fibroids.


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