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Magnetic Resonance-guided focused ultrasound (MRgFUS; Syn.: HIFU = high intensity focused ultrasound) is a safe and effective thermoablative technique to treat fibroid-related symptoms. The evidence is limited due to a lack of randomized trials. The indication for treatment by MRgFUS are symptomatic uterine fibroids. This consensus paper covers criteria to measure success, contraindications, side effects and complications of MRgFUS treatment. The role of MRgFUS in the setting of family planning is part of this publication. KEY POINTS:: · MRgFUS therapy should be based on a clear understanding of the aim of treatment and the wish of the patient.. · Success of MRgFUS/HIFU treatment should be judged by the degree of improvement (alleviation) or disappearance of fibroid-related symptoms.. · The indication for treatment by means of MRgFUS/HIFU is based on a gynecological examination incl. ultrasound performed by a specialist. Necessary prerequisite for MRgFUS/HIFU treatment is a contrast-enhanced MRI of the pelvis.. · A number of more than 5 fibroids (leiomyomata) limits the success of MRgFUS/HIFU therapy; the indication to treat fibroids exceeding 10 cm in diameter should be reviewed critically.. · A recommendation for the treatment of fibroids by MRgFUS to patients who seek to conceive cannot be given based on the current state of knowledge.. CITATION FORMAT: · Kröncke T, David M. MR-Guided Focused Ultrasound in Fibroid Treatment - Results of the 4th Radiological-Gynecological Expert Meeting. Fortschr Röntgenstr 2019; 191: 626 - 629., Competing Interests: Disclosure The authors report no conflicts of interest in this work., (© Georg Thieme Verlag KG Stuttgart · New York.)

Purpose: To analyze the cost-effectiveness of percutaneous image-guided CNBB (stereotactic-/ultrasound-guided; large/vacuum-assisted) of non-palpable breast lesions vs. OSB and to compare and discuss the results reported in the literature with results for German-speaking countries., Materials and Methods: A key word search in three databases, limited to the period from 1/1994 to 12/2006 was performed. Only original papers were selected. No published articles for German-speaking countries were identified; therefore a comprehensive data collection was made., Results: On the basis of 377 abstracts, nine studies were evaluated for final assessment. The data of German-speaking countries were compared with results reported in the literature. This study demonstrates that CNBB compared to OSB leads to reduction in cost ranging from 51-96 %. The cost reduction depends on biopsy modality and lesion type and is subject to national fluctuations. CNBB can replace a surgical procedure in 71-85 % of cases., Conclusion: Use of CNBB as an alternative to OSB has the potential to substantially reduce healthcare costs. The data are based almost exclusively on the North American literature. A potential cost reduction in the Netherlands and Switzerland confirms these findings. Future work must include cost evaluation studies for German-speaking countries since this is an issue with important national economic ramifications.