Atul Gupta MD, Presenter: Nothing to Disclose

Kirsten Zuurmond MSc, Abstract Co-Author: Nothing to Disclose

Thijs Grunhagen MSc,DPhil, Abstract Co-Author: Nothing to Disclose

Geert Maleux MD, Abstract Co-Author: Nothing to Disclose

Uterine fibroid embolization (UFE) has become an accepted and widely performed treatment for uterine leiomyomas. The procedure is typically guided by contrast angiography, which exposes both the patient and interventional staff to significant ionizing radiation. A novel technology called 3D MRA roadmapping allows real-time fusion of a patient’s previously acquired MRA with the live fluoroscopy stream, providing complete synchronization between the two during changes in c-arm angulation and table position. Here we report the first clinical experience using MRA roadmapping for UFE and compare radiation and contrast dose using this technique to UFE performed in the conventional manner with 2D angiography.

Following institutional review board approval, eight consecutive women who underwent UFE were treated using live 3D MRA roadmapping to navigate and embolize the uterine arteries. The total Dose Area Product (DAP) and contrast usage for the UFE was recorded and compared retrospectively to the DAP and contrast usage in 16 patients who underwent UFE by means of conventional 2D angiography. Statistical difference was tested using the Student's t-test with p-values <0.05 indicating significance. Data are presented as means (± standard deviations).

Technical success rate for UFE was 100% in both groups. The DAP in the MRA roadmapped group revealed a 70% dose-reduction as compared to the 2D group (202 Gy∙cm2 (± 146 Gy∙cm2) versus 670 Gy∙cm2 (± 277 Gy∙cm2), p<0.001). Contrast usage in the MRA roadmapped group was 53% lower compared to conventional 2D angiography (77.3 mL (± 50.6 mL) versus 165.7 mL (± 50.3 mL), p<0.001).

This study demonstrates the feasibility of using real-time coupling of MRA and live fluoroscopy to perform UFE. Using this novel technique, radiation exposure and contrast usage could be greatly reduced as compared to UFE performed using conventional angiography.

MRA Roadmapping, a novel image fusion technology, is proving to reduce ionizing radiation dose and contrast to patients undergoing UFE.

Gupta, A, Zuurmond, K, Grunhagen, T, Maleux, G, Uterine Fibroid Embolization Using Live MRA Roadmapping Reduces Dose and Contrast Compared to Conventional Angiography.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11012155.html