Clinical specialtyFibroids, also known as uterine fibroids, are benign growths that develop in or on the muscular wall of the uterus. Formed of muscle cells and connective tissue, they are relatively common, present in more than 50% of patients, and can sometimes impact reproductive health and other aspects of women’s health. Identification and treatment of fibroids is vital for ensuring the well-being of sufferers, who can experience pelvic pain, heavy menstrual bleeding and complicated pregnancies, amongst other symptoms and developments. With recent advancements in uterine ultrasound, such as Voluson’s Fibroid Mapping Tool, how fibroids can be mapped, identified and removed vastly improves patient outcomes and expands the abilities of surgeons and other medical professionals in women’s reproductive health.
Why is the classification and identification of fibroids crucial?
The type of fibroid present can present different challenges during surgery or considerations throughout treatment. Enhanced fibroid mapping tools can also identify information about the structure and makeup of individual fibroids, providing information that can bolster preventative steps before and during surgery.
Ultrasound mapping can identify intramural fibroids, which develop in the muscular wall of the uterus; submucosal fibroids, which grow into the inner cavity of the uterus; and subserosal fibroids, which protrude beyond the uterus. In each case, the type of surgery required and the potential impact on surrounding organs and the patient's long-term health can be better understood through ultrasound tools such as 3D mapping. “Voluson’s Fibroid Mapping Tool takes into account other features like size and typography extension of the base,” said Prof. Wouter Froyman during a recent talk on fibroid mapping “These are features you can see clearly on ultrasound, especially with newer innovations.”
Fibroid mapping using ultrasound can also provide relevant information regarding the features of individual fibroids—for example, their vascularity or echogenicity. The more vascularised a fibroid is, the more bleeding should be expected during surgery. Echogenity can indicate the difficulty with which a fibroid can be removed. The higher the calcification of a fibroid, the harder it will be and, therefore, much easier to remove. By contrast, a less calcified fibroid will be softer and likely take much longer to remove.
In both cases, this presents valuable data for any surgeon planning surgery. “For smaller fibroids that are type one and two, we can perform hysteroscopic myomectomy. On the other hand, type two deeply penetrating fibroids are more complicated to remove, requiring a more complex myomectomy than type one. Along with this classification, many other features will be involved in defining the difficulty of the surgery,” said Prof. Froyman.
Ultrasound Advancement with Voluson’s Fibroid Mapping Tool
As stated, the tools that medical professionals have available to map, identify and treat fibroids are advancing through innovative ultrasound tools powered by AI and automation. The Voluson Fibroid Mapping Tool provides users with various ultrasound views and planes through image localisation, providing better and broader data to diagnose. The tool automatically delineates the contours of the uterus and the endometrium. The user can identify fibroids on any scanning plane with a click before the software automatically produces a real-time 3D image.
Real-time, high-resolution structural imagery can be used in the diagnosis stage via non-invasive ultrasound techniques. In doing so, users can gain a deeper understanding of fibroids' type, variety, number and location and gather surgical data that will determine the best approaches before and during surgery.
Implications For Women’s Health and Patient Outcomes
In the early stages of treatment, medical practitioners can make faster, more efficient and more accurate diagnoses and better share this information with their patients. In any case, requiring surgery and preventative steps can help minimise unnecessary damage during the procedure and achieve better outcomes and faster recovery rates. In the case of fibroid surgery, a more detailed surgical plan can be created using Voluson’s Mapping Tool. This includes the identification of uterine arteries that may require temporary clamping or may be at risk of rupture during removal.
Unnecessary damage to the endometrium can also be prevented through more direct, focused surgical procedures undertaken in conjunction with uterine ultrasound. “Fibroids can appear anywhere in or around the uterus,” says Prof. Wouter Froyman. “The closer they are to the endometrium, the more extensive your dissection will be. So, the longer the excision will take, the longer the suturing will take so that a patient's bleeding will increase.” Steps can also be taken using other surgical methods in conjunction with ultrasound to prevent or detect breaches in the endometrium wall.
Additionally, using such tools prevents fibroids from being missed pre- and post-surgery; as Prof. Froyman states: “It's quite embarrassing to see patients after six weeks and recognise that there is a very deeply located fibroid against the endometrium still present. You cannot say that it is an early recurrence of fibroids - you just forgot to remove it during the procedure.” Often, fibroids can present deep inside uterine tissue, and removing one may reveal the presence of another. Voluson’s Fibroid Mapping Tool can be a valuable assistant to a surgeon when completing surgical procedures and avoiding further surgery in the event of a missed fibroid.
“The tool takes a 3D sweep of the circumference of the uterus and the delineation of the endometrium,” Prof. Wouter Froyman explained. “You can scroll through different planes, and the software will automatically delineate fibroids in their entirety and add them to the 3D reconstruction. So, you have a complete image of the uterus with all fibroids marked in real-time during surgery.” Using such tools leads to better outcomes for patients, with faster recovery times, lowered risk of further surgery being required, and faster, more accurate diagnosis of fibroids that may otherwise impact their reproductive health.
In Conclusion
Treatment of uterine fibroids continues to be an essential aspect of women’s reproductive health. As with many other medical fields, ultrasound is positively impacted by the power and potential of AI-powered tools and software sets. It is clear that the earlier and more accurate the diagnosis, the better the long-term outcomes are for patients. So, medical professionals now have more powerful tools through more precise imaging techniques and tools and the dramatic potential of algorithmic data processing.
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