Does anyone have an experience with ExAblate (MRgFUS)?

From the original comment on the ExAblate (MRgFUS) procedure:

Ruth: I’ve been investigating ExAblate as a potential candidate for over a year now, and finally had my consult at Virtua in NJ, with a 2nd opinion at Weill-Cornell in NYC. I really want to hear from anyone who has had this procedure…

Other comments: (Click the link to view the whole comment or the off-site link for more info.)

aiyin: Here’s an alternative procedure for zapping those pesky uterine fibroids. Unfortunately, it is so new my gynecologist never heard of it … http://www.universitymri.com/imageguided/fus_faq.html

Ellen: I am hoping that I will be eligible. Three SEDATED hours in an MRI, belly-down, while they blast the fibroids with ultrasound.

aiyin: Here’s more about ExAblate:
http://www.uterine-fibroids.org/index.html

The Related Post at the bottom contains information I gathered from a TIME magazine article as well as a few links to the ExAblate (MRgFUS) site.

[Edited to add the ExAblate toll-free number (US): 1 866 EXABLATE (1 866 392 2528). Thanks Randee!]

Leave a comment if you have an ExAblate experience (pre- or post-treatment), questions, or thoughts.

——————–

Related Posts:
New treatment uses sound waves to shrink uterine fibroid tumors
ExAblate 2000 (MRgFUS) non-invasive fibroid treatment receives two new associated approvals by the FDA

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389 Responses to “Does anyone have an experience with ExAblate (MRgFUS)?”

  1. michelle Says:

    Hi CJ, please tell us more about LESS. I couldn’t find anything but I guess I’m using the wrong search terms. I’m glad I had the hysterectomy … I had a great surgeon, quick surgery, easy recovery. But not everyone will be so lucky and I’d always recommend the least invasive option possible. Please let us know how your appt goes next week. Hang in there, sister!

  2. Used Ultrasound Machines Says:

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  3. Annette Says:

    I’m an Australian living in London and these are my experiences with MRgFUS in Melbourne, Australia and St Mary’s, London.

    Had ultrasound in the UK just prior to going back to Melbourne for a 2 week visit which showed multiple fibroids throughout. Saw an OBG/GYN in Malvern who said only options were hysterectomy or ‘do nothing’. Any other approaches such as myomectomy or embolization she said were not recommended which left me extremely distraught.

    Looking for more information I went to the women’s health information centre at RWH in Flemington, they were mortified at the lack of help provided by this first (female) doctor and assisted in provideing names of more knowledgeable gynae specialists for a 2nd opinion. The 2nd doctor was an infertility & laparoscopic specialist. She arranged a referral for a staging MRI to see if I was suitable for MRgFUS which I was able to get done privately the next week.

    The MRI showed at least 8 focal typical T2 fibroids scattered throughout the myometrium. The largest being intermural in the fundal region measuring 8.2 x 9.4 x 4.3. Others are: 5.4 x 3.8 x 4.3 left lateral intermural, 4.3 x 5.2 x 3.6 anterofundal intermural, 2 x 1.4 cm in mid to lower body of uterus, and 4.6 cm in the lower body. Uterus is markedly enlarged with a volume of 821cc

    The IR advised that I was not currently suitable for MRgFUS as the dominant fibroid abuts the sacral promontory (risk of nerve damage), however recommended a course of GNRH agonist for 3 months when it is probable that I will be likely to be suitable for MRgFUS.

    I then returned to London and decided to look into seeing having the MRgFUS at St Mary’s in Paddington. It’s more expensive for the procedure £4,400 vs. ~AU$5,500 but easier to coordinate rather than needing to time GNRH agonist injections around when I could book the re-assessment MRI in Melbourne, time off work etc.

    I saw the gynae at St Mary’s then had to wait to get my films reviewed by the radiologists. The Dr told me though that 6 is the maximum number they like to treat due to the amount of time on the table to do more (I have at least 8). Also the beam is only affective apparently to a depth of 12cm and she was concerned that the one at the back might be too far away. They can apparently try things like filling your bowel with air to see if it can move forward enough so that was what I was waiting to find out from the MRI review.

    Well the feedback was that I was suitable to have the MRgFUS to the St Mary’s criteria and no need for the GNRH agonist to shrink them first which was even better news. However due to the limitation in the number that they would treat plus the fact MRgFUS may only reduce the volume by 35% and symptoms by 70% I decided I’d investigate surgical options.

    I’ve now had a hysteroscopy with polyp removal (see post on how are you feeling after hysteroscopic myomectomy) and am due to have a laproscopic myomentomy on January 25.

    • Amy Says:

      Annette – thanks for a great example of thoroughly researching your options and not taking “no” for an answer!! It really helps us all to remember that we can take more charge of our health.
      Best to you!

    • Robby Ann Says:

      I just returned from Mexico City this week and had Exablation done at Medica Sur Hospital. I live in Texas, USA and do not have health insurance so we opted for Mexico as the cost is SOOO much lower there. I’ve had uterine fibroids for 5 yr now and my regular ultrasounds showed about 8 tumors ranging from 1-6 cm. This year I had begun to feel an extra amount of pressure, constipation, heavy bleeding, etc…all of the symptoms these tumors cause. My gyne has been treating me with a natural hormone balancing program which has brought relief for some time now but not totally. So after consulting with the Exablate team in Mexico City (they were excellent, spoke great english, so helpful!) we decided to make the trip. As it turned out, my MRI which we did there (again – the cost is so much lower there) showed 25 tumors! However, I was still a good candidate for the treatment since their location and size was acceptable but they felt I may need to return in 6 months for a 2nd treatment if another MRI showed tumors remaining. I was in the MRI machine 7 hr! That was not the usual treatment but they were so thorough and I had so many tumors they kept the treatment going as long as I was willing to “endure” – there is some discomfort (heat and cramping in the abdomen) and I was pretty claustrophobic but the sedative helped and actually it only felt like about 2-3 hr. I’m already feeling lots of relief, the post-surgery recovery was minimal, I had some cramping and very light spotting for about 5 days, some nausea which lasted about 2 days. The staff was so excellent and considerate – we were assigned an english translator through the whole process since our spanish is minimal. For me; I felt this was the method of treatment for me since I do not wish to have my uterus removed and go through 6 wks of bed-rest. There’s a likely chance that I will be naturally in menopause within 5-7 yr and the chances of any remaining tumors or new ones growing will be very slim. If it was to occur; I would gladly get the treatment done again – however; they were so thorough it appears for now to be 90-100% succesful! And the treatment cost was very low compared to here – about $6000 incl. the MRI’s and two nights at their Holiday Inn which was excellent. Plus the cost includes a follow-up check up and MRI which they said I could schedule within 1 yr if we want to return which we may do depending on my symptom improvement. I give the whole experience an A plus and I am so thankful for the help available from our neighbors in Mexico! They said they get alot of inquiries from the US and Canada but depending on tumor location and size they can only offer the treatment to a small percentage. I hope this review is helpful to any considering an alternative to invasive surgery. If you have health insurance it would probably be covered here in the US. But if you consider going to Medica Sur in Mexico City; it was very clean, modern, efficient and the translator took care of us like we were her family. You don’t have to suffer!

  4. Herlinda Doncaster Says:

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  5. andrea uk Says:

    Hi ladies,
    Found something that may of interest to anyone in the US who’s considering treatment and hopes for pregnancy after. There are currently trials about this which you can join, check it out at
    http://clinicaltrials.gov/show/NCT00730886

    Hope that’s of use to some one. x

  6. CJ Says:

    Here is info about LESS in the Baltimore area –
    LESS Procedures:

    LESS is an advanced minimally invasive approach in which the surgeon operates almost exclusively through a single entry point, typically, the patient’s navel. Potential advantages of LESS include better cosmetic results from a hidden scar at the base of the belly button (this surgical approach is called “scarless surgery” because patients can’t see the incision at the base of the belly button once it has healed), less pain after surgery resulting in the need to use less pain medication, and quicker recovery from fewer incisions.

    Dr. Amanda Nickles Fader, M.D. a gynecologic oncologist and minimally invasive surgeon at GBMC, is one of only a handful of gynecologic surgeons in the country trained in LESS procedures. This minimally invasive innovation has recently garnered significant interest across many medical fields, including urology, general surgery, colorectal surgery and gynecology. It remains one of the hottest topics in contemporary minimally invasive surgical research.

    Over the last year, Dr. Fader and her colleagues at the Cleveland Clinic have published some of the first studies on the use of single port surgery for gynecologic procedures and have demonstrated that this surgical approach is safe and effective when used to treat a variety of gynecologic conditions including fibroids, endometriosis, pelvic pain, ovarian cysts and pelvic masses. As a gynecologic oncologist, a surgeon who specializes in treatment of precancerous and cancerous female diseases, Dr. Fader has focused her studies on utilizing LESS for women with precancerous conditions like cervical dysplasia, those with pelvic masses or large ovarian cysts, those women at high risk for ovarian cancer who may want their ovaries removed prophylactically to prevent cancer, and for surgeries to treat some early-stage endometrial and ovarian cancers.

    Dr. Fader said, “In our first group of published studies, our preliminary data demonstrates that women who undergo single incision laparoscopies use little to no pain medicine after surgery, recover very quickly and are quite satisfied with the cosmetic outcomes because most women can’t see their hidden surgical at the base of the belly button.”

  7. Tiffany Says:

    Halt Procedure: A doc in Monterey is experimenting shrinking fibroids using electric needle laser (halt procedure). The difference between HP and MRgFUS is that Hp requires a small incision to insert the device. It seems that HP can target fibroids more accurately as it directly zaps tumors. It’s about $5K, but the doc is working with the insurance company. The doc’s name is Bruce Lee. Google halt procedure.

  8. Tiffany Says:

    Oh, forgot to mention. Halt procedure (Radio frequency) has been performed in Korea for years while it is still being experimented here in the U.S. According to the Korean doctors, HP can improve heavybleeding by almost 90%. There was risk of colon damage during the early stage, but the new generation technology doesn’t carry this risk, according to Korean doctors. There are a couple of hospitals there that perform HP in Korea and the cost is about $3K. Not too bad. I’m waiting Dr. Bruce Lee in Monterey starts HP to general public. Not called him yet since last year. Will post here if he accepts new patients.

  9. CJ Says:

    University of Virginia Health System Celebrates Opening Of World’s First Fully-Dedicated Focused Ultrasound Facility

    CHARLOTTESVILLE, Va., Sept. 8, 2009 – The University of Virginia Health System will hold a morning scientific symposium and early afternoon dedication ceremony on Monday, September 14 to mark the opening of its new MR Guided Focused Ultrasound (MRgFUS) Surgery Center, the first facility in the world that will be used exclusively for performing research and providing treatments with one of today’s most promising noninvasive medical technologies.

    Located on the grounds of the UVA Health System, the new center will launch a robust, multi-disciplinary research program to investigate the safety and efficacy of MRgFUS in treating brain, breast, prostate, bone and liver tumors and conditions such as epilepsy, stroke, chronic pain, Parkinson’s disease and essential tremor.

    Beginning in October, the center will also offer FDA-approved MRgFUS treatments to women with small, benign tumors known as uterine fibroids. Clinical offerings will expand as focused ultrasound treatments for other conditions are developed and receive FDA-approval.

    “The opening of this facility is an exciting development,” says James M. Larner, M.D., chairman of UVA’s Department of Radiation Oncology and director of the new center. “Our facility is the first to have a fully-dedicated magnet, meaning it will be used exclusively for MRgFUS research and treatments. Full-time access to equipment should accelerate the pace of our research and place UVA at the forefront of this emerging area of healthcare.”

    UVA specialists in anesthesiology, biomedical engineering, gynecology, neurology, neurosurgery, oncology, radiology, radiation oncology surgery and urology will conduct research at the center.

    Alan H. Matsumoto, M.D., interim chairman, Department of Radiology and co-director of the new center, will provide focused ultrasound treatments to patients with uterine fibroids. “This therapy will add an important option to the spectrum of treatments we offer for uterine fibroids. For some women, this noninvasive procedure will be the ideal choice,” he says.

    MRgFUS procedures are performed on an outpatient basis without general anesthesia and cause minimal discomfort and few complications, allowing patients to recover rapidly.

    Hailed as a breakthrough technology, MRgFUS integrates the visualization capabilities of magnetic resonance imaging with the intense energy that is created when multiple waves of high frequency ultrasound are directed to a treatment site. Highly precise, MRgFUS can target treatment sites as small as one millimeter in diameter.
    (continued below)

  10. CJ Says:

    Single waves of focused ultrasound are as harmless to body tissue as those emitted during diagnostic ultrasound testing. However, when waves intersect – which is what happens during focused ultrasound treatments – they become powerful enough to destroy tumors and liquefy blood clots.

    Targeted drug delivery is another promising use of focused ultrasound. In such procedures, patients receive injections of chemotherapy or other drugs, which remain inactive while the bloodstream carries them to the treatment site. When the drugs reach the targeted tumor or tissue, clinicians activate them using waves of MRgFUS energy. Such precise and localized drug delivery is expected to eliminate the side effects of chemotherapy and other powerful pharmaceuticals.

    Currently, MRgFUS has one FDA-approved application – the treatment of uterine fibroids – and more uses are anticipated. Clinical trials in several countries are now evaluating focused ultrasound’s effectiveness in treating metastatic bone tumors, breast and brain cancer, and other malignancies.

  11. Courtney Says:

    I had this procedure performed by Dr. Alan H. Matsumoto at UVA in Charlottesville and would highly recommend him and his staff.

  12. Syreeta Says:

    Hi Ladies,
    I am American; but I had the exablate procedure done in Mexico City one week ago. I went overseas because the cost was only 5,000 US dollars. The Mexican team headed by Dr. Cecilia Romero was outstanding. The cost of the procedure included 2 nights hotel stay at the Holiday Inn which is right next to the hospital. It also included transportation to and from the airport. There were no complications. Google Exablate Mexico. the name of the hospital is Medica Sur.

    • Christine Says:

      Syreeta, can I ask you about your fibroids and where they were located? How did you decide to use Exablate?

    • lee Says:

      thanks for your treatment report. how are you doing since your treatment in may??? i am thinking about getting the procedure and welcome more info about your experience.

      tx

      lee

    • Valerie Says:

      Hi Syreeta, I am considering going to Mexico City for the ExAblate procedure and I would really like to hear more about your experience there. We live in Houston, and I considered having it done at the ExAblate center in Austin, but like you found Mexico to be a less expensive option. For us, $5,000 is still too much and we are wondering if insurance will cover some of that $5,000. I will investigate that this coming week. I am in communication with both the Austin and Mexico ExAblate centers as we speak. Both very helpful and I get a “good feeling”, not like I was being suckered into something! They answer questions very thoroughly and base the answers on their previous results.

      Did you have all the MRI’s there or just the actual treatment? Did you experience any pain or discomfort during or afterwards? Were you comfortable on your flight home? How are your fibroids now? How did you feel with the sedative? I personally do not have symptoms, but my issue is that I had excruciating pain when I was pregnant with my son because the fibroid grew and degenerated. We want to have another child and of course want to get rid of this thing before it causes more problems for us! I would so appreciate any more info you can share about your experience! Thanks for sharing!

      • Amy Says:

        Hi Valerie,
        I’m from Mexico City, although I haven’t lived there since I was 17 (30+years ago). That said, there are a number of excellent doctors and hospitals in Mexico (haven’t heard of this one – more familiar with the ABC American-British-Cowdray Hospital – top notch). Just make sure you research any complication that could happen that might make it necessary for you to stay in the hospital and find out if you insurance would cover that…. Also, it’s always good to go with someone to be there for you if necessary – not to scare you, but you never know. I know someone who was recently in a car accident in Mexico and his insurance wouldn’t cover the ambulance back to the US for treatment.
        Also, according to my sister who is a nurse, nurse’s training in Mexico is a far cry from the type of training nurses get in the US. Most are more like LVNs – so if you were to have to spend a night or more, it’s good to have someone there to watch out for you. I just had a laparascopic myomectomy, and ended up staying the night – if I had to do that in a place where i couldn’t communicate as well (unless you speak Spanish well) – it definitely would have been harder. Best to you! (By the way, I am very happy with my surgery – it is so nice to know the fibroids are completely gone! One of the reasons I didn’t choose ultrasound..I had an incision in my belly button which I can’t even see any more, three incisions that are less than 1/2 inch on several areas of my belly, another one below in my hair, and one a little less than an inch above my hair on the right – they are all healing well and I went back to work just over a week later. I can’t believe I feel as good as I do! At any rate, good luck with whatever you choose to do.

      • Amy Says:

        One clarification re: my comment below – I had my surgery in the US, not Mexico. I realize now that wasn’t clear.

      • Ali Says:

        Valerie, Did you end up having the procedure? I have many questions. I called the Austin location but have to call the insurance to see if any of it is covered because it is too much to pay out of pocket. I have one fibroid and it is 7cm.

  13. Judy Says:

    Did anyone have any complications after the FUS procedure.?

  14. CJ Says:

    Has anyone had success with this procedure?
    Has anyone had it done twice? With success the second time?

  15. EB Says:

    Greetings Everyone,

    Just wanted to give an update on my exablate procedure I had in late 2008. My menses has significantly improved from 7 days a week heavy bleeding to 5 days a week of normal bleeding using 2-3 pads a day. I had a pelvic ultrasound recently and the results revealed that the fibroids from reduced down from 6.3 cm to 4.4 and my uterus shrunk from 15X8X12 to 13.9X8X10. I give God the glory. I just turned 50 years old in June and still have my cycle on schedule. I give God the glory for what He has done. I am happy with the Exablate procedure and would recommend it than trying to remove the uterus. There are some risks in the procedure but one should pray and ask God is the way to go. The exablate was done at UCLA with Dr. Steven Raman as the head radiologist. Great team to work with.

    thanks

    EB

  16. Alison Says:

    Hi, I’m wondering if anyone has tried FUS on extremely large fibroids. I have one that is 19cm, another half that size plus scattered others. I was only given the option of myomectomy or embolization and I’m wondering if the size of my fibroid is the reason?

    • Amy Says:

      Alison, don’t know if you’ll see this, but if you still have the same question, this has definitely been discussed in the older posts, just make sure you click on that link. But the answer as I recall, is that yes, that’s too big. (By the way, I”m still very happy with my laparascopic surgery. And some surgeons will remove ones as big as yours this way. (I saw Dr. Brill in San Francisco). I had the surgery in June, and I’m surprised that even now, I am still amazed (daily!) by how much more capacity my bladder and my bowel have! I also have much less constipation. All this, and he only removed two – one 10cm the other 6cm. I can’t imagine what it must be like to have a 19cm one. I’m also glad I didn’t chose this option, because there are so many unknowns (will it work or not?) and it isn’t just over, they still remain, although they shrink. In addition, I only had one (well maybe it was 2?) checkups post surgery – that’s it. I would think the exablate would require much more follow up. Best!

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  19. Alba Says:

    Hi, for what I have read this treatment is a really good option, but I couldn’t find anything about the benefits or complications for pregnancy after procedure. If anybody can tell me their experience, it will be very appreciated.

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  21. mathilda sabado Says:

    if this ExAblate procedure is so cool, Why do not we see it done in the USA? Until this occurs, I would not go to Mexico. Foreign countries are complicated, and you cannot sue them if they mess you up.

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