Use of the inversion bench in the preparation of the patient before the magnetic resonance-guided focused ultrasound (mrgfus) treatment for uterine fibroids

Backround: There are several inclusion and exclusion criteria of patients affected by symptomatic and asymptomatic, single and multiple uterine fibroids, among them the interposition of bowel that do not allow the access to the ultrasound beam (Mascaretti et al., 2016). The use of the inversion bench before the treatment is a method that allows the inclusion of some patients. Methods: from May 2016 to April 2017, 22 patients aged between 23 and 51 affected by single and multiple uterine fibroids (sized between 2 and 14 cm) have been placed on the inversion bench which allowed 15 of them to access the Magnetic Resonance-Guided Focused Ultrasound, since after a 15 minutes positioning on the inversion bench, an acoustic window was created, thus enabling the safe passage of the focused ultrasound beam. Results: In our operating unit, 22 patients have been placed on the inversion bench. Of these, 15 after the Magnetic Resonance-Guided Focused Ultrasound (MRgFUS) treatment for single and multiple uterine fibroids. Patients have been closely evaluated by means of a complete gynecological examination, a transvaginal ultrasound, an MRI with and without contrast agent. After these specialized evaluations, it is possible to determine if the patient actually is an eligible candidate for the ultrasound treatment and if there is any bowel interposition that could interfere with the treatment. The symptom evaluation has been conducted by the means of the UFS-QOL questionnaire. All the evaluations have been carried out for the selection of patients that had to undergo the focused ultrasound treatment and after the treatment, a 3 months, 6 months and 9 months follow-up has been made. The use of the inversion bench allowed 15 patients to the treatment, who otherwise would have been excluded from the Magnetic Resonance-Guided Focused Ultrasound. They have been thus treated with success and avoiding any inconvenience. Conclusions: The use of the inversion bench allowed the inclusion in the Magnetic Resonance-Guided Focused Ultrasound treatment of patients who otherwise would have been excluded. After the clinical evaluation, these patient were treated without any accident, exactly like the other patients (Mascaretti et al., 2016; Spies et al., 2002; Mascaretti et al., 2017).