To best determine if you are a candidate for this treatment, you will need to be screened by having a prone MRI of your pelvis. This is a test that your gynecologist can order and due to your history of uterine fibroids, it is usually covered by your insurance. A prone pelvic MRI will serve to give us a three-dimensional view of your uterus, fibroids and the surrounding organs, and allow the physicians to plan your treatment. The person who will schedule your prone pelvic MRI at the imaging facility will contact you for an appointment after your physician has ordered this test. Under normal circumstances, you can plan on this scan lasting no longer than one hour. Please feel free to ask the scheduler any questions or concerns you may have regarding an MRI. Click here for a referral form which you can print and have your doctor complete the necessary information.

Following this test, you and/or your physician will be contacted, and you will be informed if you are an appropriate treatment candidate for ExAblate.

Please refer to the map for the location of both Central Texas ExAblate and Central Park Imaging Center, where you may have your Pelvic MRI scan done.

Should this location be inconvenient for your screening evaluation, please contact us as soon as possible and we will locate other facilities in your area and send them instructions on how to properly perform your Pelvic MRI.

For more information visit these sites:

CDC’s Reproductive Health Information Source

The National Women’s Health information Center

AHRQ Agency for Healthcare Research and Quality – Common Uterine Conditions

Brigham and Women’s Hospital

Mayo Clinic

InSightec

During treatment, it is normal to feel a warming sensation in the pelvic region. You will be given a safety stop button that allows you to immediately stop the sonication if the treatment becomes painful.

You are conscious the entire time and provide feedback during the procedure to the physician and nurse. Afterwards you’ll be asked to rest for a few hours in the clinic, while the mild sedation wears off. Then you’ll be able to go home and resume normal activity.

First, the doctor identifies the fibroid(s) on MR images taken of your pelvic region. Then, after detailed planning, high energy focused ultrasound waves heat a small spot in the uterine fibroid to a temperature of up to 85oC. During the pulse or sonication, which lasts about 15 seconds, the doctor monitors the progress and reviews temperature-sensitive images. Since each sonication treats a very small volume, this process will be repeated until the required volume is treated, typically about 50 times. The procedure lasts about 3 hours depending upon the size and number of fibroids treated.

Following the treatment the body gradually removes the treated tissue over a period of months, but most women experience symptom improvement beginning the day following the procedure!

The patient lies in the prone position on a patient table inside the MRI during treatment. Focused ultrasound waves are directed toward the fibroid. During each “sonication” (dose of focused ultrasound), a small volume of the fibroid is ablated. After multiple sonications, the entire fibroid is ablated. A MR pelvic coil surrounding the patient is used to obtain images during treatment.

Imagine using a magnifying glass to focus the sun’s energy on a single point to create a flame to burn a leaf. The focused ultrasound energy is directed at a small volume of the fibroid, raising its temperature high enough to cause thermal ablation (killing of the cells) without impacting other tissues. Pulses of energy are repeated until the entire volume is treated.