Role of magnetic resonance imaging in patient selection for uterine artery embolization

Cura, Marco; Cura, A.; Bugnone, Alejandro N.

doi:10.1080/02841850600965047

Cited by 51 publications

(25 citation statements)

References 47 publications

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“…(2) Consider pre-treatment with GnRH agonist prior to MRgFUS. Previous studies have shown that pre-treatment of fibroids with a GnRH agonist leads to fibroid shrinkage and improved treatment outcomes following MRgFUS [9,10]. Figure 3a shows an initial screening MRI of a 14.2×9.9-cm fibroid.…”

Section: Fibroid Sizementioning

confidence: 95%

“…The location and size of the fibroids have clinical significance [10], for example, submucosal fibroids that project into the endometrial canal are a common cause of uterine bleeding, while subserosal leiomyomas that are beneath the serosa may compress adjacent organs and cause specific symptoms in the bladder and intestines [10]. If a patient's symptoms do not correlate with the size and location of the leiomyomas, MRgFUS may not be the appropriate treatment.…”

Section: Relevance To Symptomsmentioning

confidence: 98%

“…This fibroid was not treated. Publications show that injection of GnRH agonist for 3 consecutive months may result in diminished vascularization of the fibroids [10,18].…”

Section: Fibroid Vascularitymentioning

confidence: 99%

See 2 more Smart Citations

Patient selection guidelines in MR-guided focused ultrasound surgery of uterine fibroids: a pictorial guide to relevant findings in screening pelvic MRI

et al. 2008

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Uterine leiomyomas (fibroids), the most common benign tumor in women of childbearing age, can cause symptoms including dysmenorrhea, menorrhagia, urinary symptoms, pain and infertility. Hysterectomy is a common approach to treating uterine fibroids, and less invasive surgical approaches such as myomectomy and uterine artery embolization also have been shown to alleviate symptoms. Magnetic resonance-guided focused ultrasound surgery (MRgFUS) is the only totally non-invasive surgical approved method for treating uterine fibroids. In clinical trials, MRgFUS resulted in significant relief of uterine fibroid symptoms. The safe and effective use of MRgFUS is affected by fibroid type and location, position relative to adjacent anatomical structures and the presence of co-existent pelvic disease. Additionally, successful outcomes with MRgFUS have been correlated with the volume of fibroids ablated during the procedure. Thus, selection of patients in whom sufficient fibroid volumes can be treated safely using the MRgFUS system is critical for successful outcomes. The MR images in this pictorial essay provide examples of uterine fibroids for which MRgFUS should be considered and is designed to facilitate the selection of patients for whom MRgFUS is most likely to provide sustained symptom relief.

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Section: Fibroid Sizementioning

confidence: 95%

Section: Relevance To Symptomsmentioning

confidence: 98%

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Patient selection guidelines in MR-guided focused ultrasound surgery of uterine fibroids: a pictorial guide to relevant findings in screening pelvic MRI

et al. 2008

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“…Therefore, they should be analyzed and reported. As proclaimed by Cura et al (15) , it is of paramount importance to detect intracavitary submucosal or pedunculated sub-serosal leiomyomas with a narrow stalk before UFE. Initially, it was supposed that the latter is a relative contra-indication to UFE for fear of risk of separation from the uterus.…”

Section: Discussionmentioning

confidence: 99%

“…Post embolization follow-up show an excellent response with no subsequent detachment or further complications. Furthermore, according to Cura et al (15) , if there is remarkable parasitization of ovarian vasculature, consideration may be given to be embolized at the time of UFE, or perhaps at a later date if there is no significant symptom relief following UFE. We had 1 case with pelvic pain and pressure symptoms attributable to solitary huge myoma that shows auxiliary supply from ovarian vessels evident at pre-embolization angiography.…”

Section: Discussionmentioning

confidence: 99%

Measurement of Uterine Leiomyomata Volume Pre and Post Uterine Artery Embolization Aided by MRI

Aly

Abdullah²,

Botros³

2018

The Egyptian Journal of Hospital Medicine

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Background: uterine fibroid embolization (UFE) is now evolving to be the first-line treatment for symptomatic uterine leiomyomata alongside the conventional surgical treatment of hysterectomy and myomectomy. Cochrane review comprises six RCTs comparing UAE versus hysterectomy or myomectomy for management of symptomatic leiomyomata where UFE had similar short and midterm outcomes, inclusive of symptomatic relief, quality of life and patient satisfaction, while benefiting from uterine preservation, shorter hospital stay and a faster recovery before resuming ordinary life activities. These benefits are in line with the minimally invasive nature of the embolization procedures. Aim of the Work: t this study aimed to review and illustrate the role of MR imaging in the pre-and post-procedural assessment for uterine fibroid patients undergoing uterine artery embolization. Patients and Methods: the current study was carried out in Radiodiagnosis Department, Faculty of Medicine, Ain shams University and specialized private radiology centers during the period between April 2017 and December 2017. It included 30 patients that were referred from gynecology clinic with their ultrasonographic reports to Radiodiagnosis Department, body imaging unit with a view to carry-out pelvic MRI with contrast. Results: imaging follow-up via pelvic MRI with contrast was obtained in 30 patients at 3, 6 months after treatment. The mean uterine volume was reduced by 25% (standard deviation was SD 0.03763) 3 months after treatment and was further reduced by a mean of 30% (SD 0.02638) by six months after treatment. Post-procedural subtraction MRI revealed mean myoma enhancement to be 5.6 + 0.5 SI in contrast to 133.4 + 18.3 SI prior to UFE. The mean dominant fibroid volume reduced by 34 % (SD 0.09247) after 3 months, 44 % (SD 0.05994) after 6 months. A cumulative reduction in both uterine and dominant leiomyoma mean volume from baseline to 6 months post -UAE was evident with significant interval changes between 3, 6 months follow up (p 0.000) Conclusion: the MRI findings following UAE vary with the interval from embolization and success of the procedure. MRI with its multiplanar capabilities was typically employed to evaluate the uterus following UAE for fibroid infarction, size reduction, location change, persistent enhancement, fibroid recurrence, changes in adenomyosis, and unexpected complications that may require surgical intervention or identify women who would benefit from repeated UAE. Recommendations: further studies on a larger scale of patients are needed to confirm the results obtained by this work.

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EP29.12: Uncommon complication of uterine artery embolisation: expulsion of infarcted myoma and uterine sepsis

J¹,

Crespo²,

Ganesh³

et al. 2016

Ultrasound in Obstet & Gyne

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Role of magnetic resonance imaging in patient selection for uterine artery embolization

Cited by 51 publications

References 47 publications

Patient selection guidelines in MR-guided focused ultrasound surgery of uterine fibroids: a pictorial guide to relevant findings in screening pelvic MRI

Patient selection guidelines in MR-guided focused ultrasound surgery of uterine fibroids: a pictorial guide to relevant findings in screening pelvic MRI

Measurement of Uterine Leiomyomata Volume Pre and Post Uterine Artery Embolization Aided by MRI

EP29.12: Uncommon complication of uterine artery embolisation: expulsion of infarcted myoma and uterine sepsis

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