Uterine-Sparing Interventional Techniques for Managing Fibroids

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification for enrollments starting after February 14, 2023:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Magnetic Resonance Imaging: 0.25
Procedures: 0.25
Body: 0.25

Registered Radiologist Assistant: 2.00
Patient Care: 0.25
Patient Management: 0.25
Procedures: 1.75
Abdominal Section: 1.75

Sonography: 0.25
Procedures: 0.25
Gynecology: 0.25

Vascular-Interventional Radiography: 2.00
Patient Care: 0.25
Patient Interactions and Management: 0.25
Procedures: 1.75
Vascular Interventional Procedures: 1.75

Outline

1. Introduction
2. Clinical Features (Signs and Symotoms
3. Imaging Classification
4. Noninterventional and Surgical Treatment Options
   1. Pharmacotherapy
   2. Surgical Treartment
5. Uterine Artery (Fibroid) Embolization
   1. Procedure History
   2. Pelvic Arterial Anatomy and Pitfalls
   3. Technical Details and Costs
   4. Patient Selection
   5. Outcomes
   6. Fertility and Pregnancy
6. Focused Ultrasound Therapy
   1. Patient Selection
   2. Patient Preparation and Procedure
   3. Complications
   4. Outcomes
7. Future Directions
8. Conclusion

Objectives

Upon completion of this course, students will:

1. know the other name of uterine fibroids
2. describe the prevalence and average population statistics affected by uterine fibroids
3. be familiar with uterine fibroids and their origin
4. describe the symptoms associated with uterine fibroids
5. understand the most common and least common types of fibroids and identify the symptoms associated with each type
6. describe the advantages of MRI in the pretreatment planning of patients with fibroids
7. know the medication therapies used to treat fibroids and their limitations
8. discuss the surgical treatments of uterine fibroids
9. identify the most common variations of uterine artery branching patterns
10. describe the risks of inadvertent embolization of the cervicovaginal artery
11. understand the importance of evaluating for utero-ovarian anastomosis prior to embolization
12. discuss how the internal iliac arteries and uterine arteries are catheterized during UAE
13. be familiar with embolic agents and their use in the embolization of fibroids
14. describe how a physician can determine the endpoint of the UAE procedures
15. identify practices patients should avoid post-UAE procedure
16. discuss postembolization syndrome
17. identify contraindications of the UAE procedure
18. discuss post-UAE procedure outcomes
19. be familiar with complications of UAE
20. discuss complications of UAE in relation to fertility and pregnancy
21. understand the development of MR-guided FUS for the treatment of symptomatic fibroids
22. describe how FUS/HIFU is used to treat uterine fibroids
23. define sonication
24. understand how MRI is used to monitor FUS therapy during the ablation
25. know the limitations of MR-guided FUS
26. discuss factors to consider when selecting patients for MR-guided FUS
27. be familiar with the techniques to displace the bowel prior to MR-guided FUS
28. understand the pre-procedure preparation of a patient for MR-guided FUS
29. identify the safe focal spot distance of the ultrasound to prevent sacral nerve damage in FUS therapy procedures
30. be familiar with the use of electronic fiducial markers during FUS therapy
31. identify the symptoms of complications during FUS therapy
32. be familiar with post-procedure care of patients receiving FUS therapy
33. discuss patient complications after MR-guided FUS therapy
34. understand correlations between nonperfused volumes and FUS procedure outcomes
35. identify imaging modalities currently being considered for future use in the treatment of uterine fibroids