Limited Efficacy of Uterine Artery Embolization for Cervical Leiomyomas

Kim, Man Deuk; Lee, Myung Su; Jung, Dae Chul; Park, Sung Il; Lee, Mu Sook; Won, Jong Yun; Lee, Do Yun; Lee, Kwang Hun

doi:10.1016/j.jvir.2011.10.020

Cited by 32 publications

(20 citation statements)

References 22 publications

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“…Though not contraindicated for UFE, it is valuable to visualize pedunculated leiomyomas for pre-treatment planning [4, 43, 44]. Cervical leiomyomas may not have a beneficial outcome after UFE [45]. Finally, it is crucial for the outcome of UFE that leiomyomas are vascularized, since a treatment response cannot be expected in a degenerated leiomyoma.…”

Section: Discussionmentioning

confidence: 99%

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European Society of Urogenital Radiology (ESUR) Guidelines: MR Imaging of Leiomyomas

Weston

Nougaret

et al. 2018

Eur Radiol

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ObjectiveThe aim of the Female Pelvic Imaging Working Group of the European Society of Urogenital Radiology (ESUR) was to develop imaging guidelines for MR work-up in patients with known or suspected uterine leiomyomas.MethodsGuidelines for imaging uterine leiomyomas were defined based on a survey distributed to all members of the working group, an expert consensus meeting at European Congress of Radiology (ECR) 2017 and a critical review of the literature.ResultsThe 25 returned questionnaires as well as the expert consensus meeting have shown reasonable homogeneity of practice among institutions. Expert consensus and literature review lead to an optimized MRI protocol to image uterine leiomyomas. Recommendations include indications for imaging, patient preparation, MR protocols and reporting criteria. The incremental value of functional imaging (DWI, DCE) is highlighted and the role of MR angiography discussed.ConclusionsMRI offers an outstanding and reproducible map of the size, site and distribution of leiomyomas. A standardised imaging protocol and method of reporting ensures that the salient features are recognised. These imaging guidelines are based on the current practice among expert radiologists in the field of female pelvic imaging and also incorporate essentials of the current published MR literature of uterine leiomyomas.Key Points• MRI allows comprehensive mapping of size and distribution of leiomyomas.• Basic MRI comprise T2W and T1W sequences centered to the uterus.• Standardized reporting ensures pivotal information on leiomyomas, the uterus and differential diagnosis.• MRI aids in differentiation of leiomyomas from other benign and malignant entities, including leiomyosarcoma.Electronic supplementary materialThe online version of this article (10.1007/s00330-017-5157-5) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

“…If enhancement persists, repeat embolization of collateral blood supply or other treatment options may be considered [34, 45]. …”

Section: Discussionmentioning

confidence: 99%

European Society of Urogenital Radiology (ESUR) Guidelines: MR Imaging of Leiomyomas

Weston

Nougaret

et al. 2018

Eur Radiol

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“…This distinction is especially important if targeted therapy or surgery is being considered. Cervical leiomyomas tend to be less responsive to treatment with arterial embolization than are uterine body leiomyomas (82).…”

Section: Leiomyomasmentioning

confidence: 98%

US of the Nongravid Cervix with Multimodality Imaging Correlation: Normal Appearance, Pathologic Conditions, and Diagnostic Pitfalls

Wildenberg¹,

Yam²,

Langer³

et al. 2016

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The adult uterine cervix may exhibit a wide variety of pathologic conditions that include benign entities (eg, cervicitis, hyperplasia, nabothian cysts, cervical polyps, leiomyomas, endometriosis, and congenital abnormalities) as well as malignant lesions, particularly cervical carcinoma. In addition, lesions that arise in the uterine body may secondarily involve the cervix, such as endometrial carcinoma and prolapsed intracavitary masses. Many of these conditions can be identified and characterized at ultrasonography (US), which is considered the first-line imaging examination for the female pelvis. However, examination of the cervix is often cursory during pelvic US, such that cervical disease may be overlooked or misdiagnosed. Transabdominal US of the cervix may not afford sufficient spatial resolution to depict cervical disease in many patients; therefore, endovaginal US is considered the optimal technique. Use of supplemental imaging techniques, particularly the application of transducer pressure on the cervix, may be helpful. This review describes the normal appearance of the cervix at US, the appearance of cervical lesions and conditions that mimic abnormalities at US, and optimal US techniques for evaluation of the cervix. This information will help radiologists detect and diagnose cervical abnormalities more confidently at pelvic US. Online supplemental material is available for this article.

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“…Cervical fibroids also are difficult to treat, likely also because of vascular supply other than the uterine arteries. 13 Submucosal fibroids, even those that are completely intracavitary, will respond well to embolization and they are not a contraindication. However, those small enough for hysteroscopic resection might be best treated surgically, given the limited morbidity and rapid recovery associated with hysteroscopy in skilled hands.…”

Section: Patient Selectionmentioning

confidence: 99%

Current Role of Uterine Artery Embolization in the Management of Uterine Fibroids

Spies

2016

Clinical Obstetrics &Amp; Gynecology

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Uterine artery embolization (UAE) is a well-established therapy for uterine fibroids, with safety and efficacy demonstrated in several comparative randomized trials. It is a minimally invasive procedure, which allows for rapid recovery and return to normal activities. Most studies demonstrate outcomes similar to those of myomectomy with a reintervention rate of 20% to 30% at 5 years after therapy. While pregnancy is often successful after UAE, limited comparative data suggest that myomectomy may be preferred in those patients who have not had prior fibroid interventions. UAE should be discussed as an option for most women presenting for treatment of fibroids.

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Limited Efficacy of Uterine Artery Embolization for Cervical Leiomyomas

Cited by 32 publications

References 22 publications

European Society of Urogenital Radiology (ESUR) Guidelines: MR Imaging of Leiomyomas

European Society of Urogenital Radiology (ESUR) Guidelines: MR Imaging of Leiomyomas

US of the Nongravid Cervix with Multimodality Imaging Correlation: Normal Appearance, Pathologic Conditions, and Diagnostic Pitfalls

Current Role of Uterine Artery Embolization in the Management of Uterine Fibroids

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