Marianne J Voogt

Publications (8) View all

• Article: MR Thermometry Analysis of Sonication Accuracy and Safety Margin of Volumetric MR Imaging-guided High-Intensity Focused Ultrasound Ablation of Symptomatic Uterine Fibroids.

  Young-Sun Kim, Hervé Trillaud, Hyunchul Rhim, Hyo K Lim, Willem Mali, Marianne Voogt, Jörg Barkhausen, Thomas Eckey, Max O Köhler, Bilgin Keserci, Charles Mougenot, Shunmugavelu D Sokka, Jouko Soini, Heikki J Nieminen
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  ABSTRACT: Purpose: To evaluate the accuracy of the size and location of the ablation zone produced by volumetric magnetic resonance (MR) imaging-guided high-intensity focused ultrasound ablation of uterine fibroids on the basis of MR thermometric analysis and to assess the effects of a feedback control technique. Materials and Methods: This prospective study was approved by the institutional review board, and written informed consent was obtained. Thirty-three women with 38 uterine fibroids were treated with an MR imaging-guided high-intensity focused ultrasound system capable of volumetric feedback ablation. Size (diameter times length) and location (three-dimensional displacements) of each ablation zone induced by 527 sonications (with [n = 471] and without [n = 56] feedback) were analyzed according to the thermal dose obtained with MR thermometry. Prospectively defined acceptance ranges of targeting accuracy were ±5 mm in left-right (LR) and craniocaudal (CC) directions and ±12 mm in anteroposterior (AP) direction. Effects of feedback control in 8- and 12-mm treatment cells were evaluated by using a mixed model with repeated observations within patients. Results: Overall mean sizes of ablation zones produced by 4-, 8-, 12-, and 16-mm treatment cells (with and without feedback) were 4.6 mm ± 1.4 (standard deviation) × 4.4 mm ± 4.8 (n = 13), 8.9 mm ± 1.9 × 20.2 mm ± 6.5 (n = 248), 13.0 mm ± 1.2 × 29.1 mm ± 5.6 (n = 234), and 18.1 mm ± 1.4 × 38.2 mm ± 7.6 (n = 32), respectively. Targeting accuracy values (displacements in absolute values) were 0.9 mm ± 0.7, 1.2 mm ± 0.9, and 2.8 mm ± 2.2 in LR, CC, and AP directions, respectively. Of 527 sonications, 99.8% (526 of 527) were within acceptance ranges. Feedback control had no statistically significant effect on targeting accuracy or ablation zone size. However, variations in ablation zone size were smaller in the feedback control group. Conclusion: Sonication accuracy of volumetric MR imaging-guided high-intensity focused ultrasound ablation of uterine fibroids appears clinically acceptable and may be further improved by feedback control to produce more consistent ablation zones. © RSNA, 2012.
  Radiology 09/2012; 265(2):627-637. · 5.73 Impact Factor
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  Available from: Marianne J Voogt

  Article: Targeted vessel ablation for more efficient magnetic resonance-guided high-intensity focused ultrasound ablation of uterine fibroids.

  Marianne J Voogt, Marijn van Stralen, Marlijne E Ikink, Roel Deckers, Koen L Vincken, Lambertus W Bartels, Willem P Th M Mali, Maurice A A J van den Bosch
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  ABSTRACT: To report the first clinical experience with targeted vessel ablation during magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) treatment of symptomatic uterine fibroids. Pretreatment T1-weighted contrast-enhanced magnetic resonance angiography was used to create a detailed map of the uterine arteries and feeding branches to the fibroids. A three-dimensional overlay of the magnetic resonance angiography images was registered on 3D T2-weighted pretreatment imaging data. Treatment was focused primarily on locations where supplying vessels entered the fibroid. Patients were followed 6 months after treatment with a questionnaire to assess symptoms and quality of life (Uterine Fibroid Symptom and Quality of Life) and magnetic resonance imaging to quantify shrinkage of fibroid volumes. In two patients, three fibroids were treated with targeted vessel ablation during MR-HIFU. The treatments resulted in almost total fibroid devascularization with nonperfused volume to total fibroid volume ratios of 84, 68, and 86%, respectively, of treated fibroids. The predicted ablated volumes during MR-HIFU in patients 1 and 2 were 45, 40, and 82 ml, respectively, while the nonperfused volumes determined immediately after treatment were 195, 92, and 190 ml respectively, which is 4.3 (patient 1) and 2.3 (patient 2) times higher than expected based on the thermal dose distribution. Fibroid-related symptoms reduced after treatment, and quality of life improved. Fibroid volume reduction ranged 31-59% at 6 months after treatment. Targeted vessel ablation during MR-HIFU allowed nearly complete fibroid ablation in both patients. This technique may enhance the use of MR-HIFU for fibroid treatment in clinical practice.
  CardioVascular and Interventional Radiology 12/2011; 35(5):1205-10. · 2.09 Impact Factor
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  Available from: Marianne J Voogt

  Article: Uterine fibroid embolisation for symptomatic uterine fibroids: a survey of clinical practice in Europe.

  Marianne J Voogt, Mark J Arntz, Paul N M Lohle, Willem P Th M Mali, Leo E H Lampmann
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  ABSTRACT: To assess current uterine fibroid embolisation (UFE) practice in European countries and determine the clinical environment for UFE in different hospitals. In May 2009, an invitation for an online survey was sent by e-mail to all members of the Cardiovascular and Interventional Radiologic Society of Europe, representing a total number of 1,250 different candidate European treatment centres. The survey covered 21 questions concerning local UFE practice. A total of 282 respondents completed the questionnaire. Fifteen questionnaires were excluded because they were doubles from centres that had already returned a questionnaire. The response rate was 267 of 1,250 centres (21.4%). Ninety-four respondents (33%) did not perform UFE and were excluded, and six centres were excluded because demographic data were missing. The remaining 167 respondents from different UFE centres were included in the study. Twenty-six percent of the respondents were from the United Kingdom (n = 43); 16% were from Germany (n = 27); 11% were from France (n = 18); and the remaining 47% (n = 79) were from other European countries. Most centres (48%, n = 80) had 5 to 10 years experience with UFE and performed 10 to 50 procedures annually (53% [n = 88]) of respondents). Additional demographic data, as well as specific data on referral of patients, UFE techniques used, and periprocedural and postprocedural, care will be provided. Although UFE as an alternative treatment for hysterectomy or myomectomy is widespread in Europe, its impact on the management of the patient with symptomatic fibroids seems, according to the overall numbers of UFE procedures, somewhat disappointing. Multiple factors might be responsible for this observation.
  CardioVascular and Interventional Radiology 08/2011; 34(4):765-73. · 2.09 Impact Factor
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  Available from: Marianne J Voogt

  Article: [MRI-guided 'high-intensity focused ultrasound': non-invasive thermoablation of tumours].

  Marianne J Voogt, Maurice A A J van den Bosch
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  ABSTRACT: MRI-guided 'high-intensity focused ultrasound' (MR-HIFU) is a new, image-guided, non-invasive technique which enables treatment of benign and malignant tumours by thermoablation by ultrasound waves. The treatment is completely guided by MRI, which offers advantages for therapy planning, monitoring and visualisation of the treatment result. MR-HIFU has a broad spectrum of applications, including ablation of uterine fibroids, breast cancer, and liver metastases. Most of these applications are still under research. The advantage of the non-invasive character of the treatment is that it can be performed on an outpatient basis and that recovery is fast. The University Medical Center Utrecht, the Netherlands, has a MR-HIFU system that, as well as for pre-clinical experimental applications, is used for clinical treatment of uterine fibroids.
  Nederlands tijdschrift voor geneeskunde 01/2010; 154:A1824.
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  Available from: Marianne J Voogt

  Article: Sexual functioning and psychological well-being after uterine artery embolization in women with symptomatic uterine fibroids.

  Marianne J Voogt, Jolanda De Vries, Willem Fonteijn, Paul N M Lohle, Peter F Boekkooi
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  ABSTRACT: To assess the effects of uterine artery embolization (UAE) on psychological and sexual well-being 3 months after treatment. Prospective study. Large teaching hospital in Tilburg, the Netherlands. 141 Premenopausal women with symptomatic uterine fibroids. UAE for symptomatic fibroids. Changes in scores on a questionnaire concerning sexual well-being (ranging from 0 to 32, a higher score indicating better functioning) and a questionnaire concerning psychological well-being (SCL-90, ranging from 0 to 360, a higher score indicating more emotional and somatic concerns). The total score for sexual functioning showed a statistically significant increase from 20.3 to 22.7, 3 months after UAE, indicating that sexual functioning improved. Thirty-four percent and 37% of women reported an increase in sexual activity and desire. The percentage of women reporting sexual problems of lubrication, orgasm, or pain decreased 7%, 36%, and 14%, respectively. The total SCL-90 score showed a statistically significant decrease from 133 to 116, 3 months after UAE, indicating a decrease in emotional and somatic concerns. Sexual and psychological well-being improved significantly 3 months after UAE in women with symptomatic uterine fibroids. Sixty-eight percent had an increase in the total score for sexual functioning. Problems with sexual functioning were statistically significantly decreased.
  Fertility and sterility 09/2008; 92(2):756-61. · 3.97 Impact Factor