Nagy N. N. Naguib MSc, Presenter: Nothing to Disclose

Nour-Eldin Abdelrehim Nour-Eldin MSc,MD, Abstract Co-Author: Nothing to Disclose

Thomas Lehnert MD, Abstract Co-Author: Nothing to Disclose

Tatjana Gruber-Rouh, Abstract Co-Author: Nothing to Disclose

Ahmed Mohamed Tawfik MBBCH, MS, Abstract Co-Author: Nothing to Disclose

Thomas Josef Vogl MD, Abstract Co-Author: Nothing to Disclose

To test if pre-embolization leiomyoma enhancement on MRI correlates with the leiomyoma volume change at 3 months follow-up after successful uterine artery embolization (UAE), enabling its use as one of the parameters predicting embolization outcome.

The study was approved by the institutional review board. An informed consent was obtained from all patients. The study was prospectively performed on 20 females (Age Range: 37-49 years, Mean: 44.7, SD: 2.83). MRI was performed before UAE and the degree of enhancement was calculated as the ratio of tumor to muscle enhancement. Muscle enhancement was measured by drawing two equal regions of interest (ROIs) in both iliacus muscles and the average value was calculated. The leiomyoma enhancement was measured by manually drawing ROIs around the individual leiomyomas in each patient. Overall 83 leiomyomas were evaluated. The volume of each leiomyoma was calculated before and 3 months after successful bilateral UAE using contrast-enhanced MRI. Correlation was tested using Spearman Rank correlation test.

Before UAE the mean initial leiomyoma volume was 52.98 ml +/- 104.4 (Range: 0.6 - 495.3 ml). At 3 months follow-up the mean leiomyoma volume was 29.2 ml +/- 69.6 (Range: 0 – 353.5 ml) thus the percentage volume reduction was in the mean of 62.9% +/- 22.8 (Range: 32.2% – 100%). The tumor to muscle enhancement ratio showed a mean value of 2.21 +/- 0.6 (Range: 0.84 – 3.58). Statistical analysis showed a statistically significant (p = 0.046) positive correlation between the tumor to muscle enhancement ratio and the percentage of volume reduction at 3 months follow-up (Spearman Rank correlation = 0.22).

A statistically significant correlation was detected between the leiomyoma to muscle enhancement ratio and the 3 months follow-up leiomyoma volume reduction.

The degree of pre-embolization leiomyoma enhancement on MRI calculated by the tumor to muscle enhancement ratio can predict the percentage of leiomyoma volume change at 3 months follow-up.

Naguib, N, Nour-Eldin, N, Lehnert, T, Gruber-Rouh, T, Tawfik, A, Vogl, T, MR-Imaging before Uterine Artery Embolization: Correlation between the Pre-embolization Leiomyoma Enhancement and the Leiomyoma Volume Change at Follow-up.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9012361.html