Sohi Bae MD, Presenter: Nothing to Disclose

Man Deuk Kim MD, Abstract Co-Author: Nothing to Disclose

Shin Jae Lee, Abstract Co-Author: Nothing to Disclose

Gyoung Min Kim MD, Abstract Co-Author: Nothing to Disclose

Sung Il Park MD, Abstract Co-Author: Nothing to Disclose

Jong Yun Won MD, Abstract Co-Author: Nothing to Disclose

Do Yun Lee MD, Abstract Co-Author: Nothing to Disclose

To evaluate the effect of the degree of necrosis in patients with adenomyosis after uterine artery embolization (UAE) on symptom recurrence at mid-term clinical follow-up.

Fifty patients who underwent UAE for symptomatic adenomyosis were retrospectively analyzed. All patients underwent contrast-enhanced magnetic resonance imaging (MRI) at baseline and 3 months after UAE, and were followed up clinically for at least 18 months. The embolic agent contained non-spherical polyvinyl alcohol particles. The percentage of necrosis was measured at the 3-month follow-up MRI using Aquarius iNtuition® software. Patients were divided into 3 groups according to the percentage of necrosis: group A (90–100%, n = 35), group B (10–89%, n = 7), and group C (0–9%, n = 8). The clinical recurrence was compared among groups for up to 48 months. The cut-off percentage of necrosis to predict clinical recurrence was estimated.

Among the 50 patients, 25 patients had focal adenomyosis and 25 patients had diffuse adenomyosis. The cumulative rates of symptom recurrence at 4 years were 14.3%, 14.3%, and 75% in groups A, B, and C, respectively. Group A had a significantly longer median recurrence-free time than group C (42.18 months vs. 12.88 months; p < 0.001). No significant difference in the recurrence-free time was noted between groups A and B (42.18 months vs. 41.50 months; p = 0.933). The hazard ratio for symptom recurrence between groups A and C was 16.7 (95% confidence interval [CI]: 4.24, 65.34; p >0.001). There was no significant difference in the hazard ratio for symptom recurrence between groups A and B (hazard ratio, 1.1; 95% CI: 0.13–9.37; p = 0.935). The cut-off point percentage of necrosis to predict symptom recurrence was estimated at 34.3% (sensitivity, 0.58 [95% CI: 0.28–0.85]; specificity, 0.87 [95% CI: 0.72–0.96]; area under the curve 0.721).

The percentage of necrosis in patients with adenomyosis after UAE may predict symptom recurrence at the mid-term follow-up. The cut-off percentage of necrosis to predict symptom recurrence was 34.3%, with 58.4% sensitivity and 86.8% specificity.

Necrosis of adenomyosis after UAE is mandatory for durability. The percentage of necrosis of adenomyosis may predict symptom recurrence at the mid-term follow-up.

Bae, S, Kim, M, Lee, S, Kim, G, Park, S, Won, J, Lee, D, Uterine Artery Embolization for Adenomyosis: Percentage of Necrosis Predicts Mid-term Clinical Recurrence.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14005487.html