Use of diagnostic tools for the management of uterine fibroids

Mauricio Abrao, MD: For us to discuss the details of treatment options, it is important to talk about imaging for the diagnosis of fibroids because the decision on how to treat begins with a correct diagnosis. We had great improvements in ultrasound and MRI. What do you think of what we have now, Jessica?

Jessica A. Shepherd, MD, MBA, FACOG: Regarding treatment goals and imaging, I always send every patient for an ultrasound. I like when they come from a family doctor or an internal doctor who sends them with an ultrasound. It’s very useful. Over the past few years in my practice, I have found that MRI has had a good impact in helping them understand and see, and also develop a treatment management plan. There are definitely patients who have had an ultrasound for something else, possibly a GI [gastrointestinal] problem, where fibroids are noted on ultrasound or MRI. How do we use this imagery and information to help guide patients who may have had asymptomatic fibroids and now know they have fibroids?

With patients who have symptomatic issues with their fibroids, how do we ensure they understand the depth and breadth of the disease process and what treatment options are available to them from an imaging perspective? Because frankly, I find that when patients see it in imagery, it puts them in another realm of fear to some degree. How do we mitigate this? How do we allow them to see that imaging is very useful for a doctor, but can actually help us more when it comes to a medical or surgical management plan or a combination of both?

Mauricio Abrao, MD: I agree. A very relevant thing is that there are new protocols to allow us to differentiate fibroids from sarcomas by imaging, mainly by MRI, for example. It is important for us to define the treatment. Improved imaging is something to mention in a discussion like this because of its beneficial impact on treatment.

Transcript edited for clarity


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