Three-dimensional quantitative assessment of uterine fibroid response after uterine artery embolization using contrast-enhanced MR imaging

Julius Chapiro, Rafael Duran, Mingde Lin, John D. Werner, Zhijun Wang, Rüdiger Schernthaner, Lynn Jeanette Savic, Mark L. Lessne, Jean François Geschwind, Kelvin Hong

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose To evaluate the clinical feasibility and diagnostic accuracy of three-dimensional (3D) quantitative magnetic resonance (MR) imaging for the assessment of total lesion volume (TLV) and enhancing lesion volume (ELV) before and after uterine artery embolization (UAE). Materials and Methods This retrospective study included 25 patients with uterine fibroids who underwent UAE and received contrast-enhanced MR imaging before and after the procedure. TLV was calculated using a semiautomated 3D segmentation of the dominant lesion on contrast-enhanced MR imaging, and ELV was defined as voxels within TLV where the enhancement exceeded the value of a region of interest placed in hypoenhancing soft tissue (left psoas muscle). ELV was expressed in relative (% of TLV) and absolute (in cm3) metrics. Results were compared with manual measurements and correlated with symptomatic outcome using a linear regression model. Results Although 3D quantitative measurements of TLV demonstrated a strong correlation with the manual technique (R2 = 0.93), measurements of ELV after UAE showed significant disagreement between techniques (R2 = 0.72; residual standard error, 15.8). Six patients (24%) remained symptomatic and were classified as nonresponders. When stratified according to response, no difference in % ELV between responders and nonresponders was observed. When assessed using cm3 ELV, responders showed a significantly lower mean ELV compared with nonresponders (4.1 cm3 [range, 0.3-19.8 cm3] vs 77 cm3 [range, 11.91-296 cm3]; P <.01). Conclusions The use of segmentation-based 3D quantification of lesion enhancement is feasible and diagnostically accurate and could be considered as an MR imaging response marker for clinical outcome after UAE.

Original languageEnglish (US)
Pages (from-to)670-678.E2
JournalJournal of Vascular and Interventional Radiology
Volume26
Issue number5
DOIs
StatePublished - May 1 2015

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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