Uterine Artery Embolization of Uterine Leiomyomas: Predictive MRI Features of Volumetric Response

Kurban, Lutfi; Metwally, Hesham; Abdullah, Mudar; Kerban, Abdurzag; Oulhaj, Abderrahim; Alkoteesh, Jamal Aldeen

doi:10.2214/ajr.20.22906

Cited by 6 publications

(6 citation statements)

References 35 publications

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“…In particular, they claimed that this different response might be correlated to the different vascularization of small myomas, which is mainly sustained by the collaterals surrounding the uterine walls. Finally, similar to the present study, other Authors found no correlation between baseline uterine dimension and percentage reduction in volume after UAE [ 48 , 49 , 50 , 51 , 52 ]. These conflicting results are difficult to explain for several possible reasons.…”

Section: Discussionsupporting

confidence: 89%

“…Some earlier reports of UAE [ 42 , 43 , 44 ] suggested that larger fibroid size, as well as a bigger overall uterine volume, are associated with poorer clinical outcomes and a greater risk of complications, with an increased need for hysterectomy. For example, in one study [ 50 ], the mean leiomyoma volumetric response was significantly higher in the small leiomyoma group compared with the large leiomyoma group, with a 10.2% greater volumetric response. In particular, UAE for massively enlarged uterine fibroid could be less effective because of more extensive collateral circulation.…”

Section: Discussionmentioning

confidence: 99%

“…Some earlier reports suggested that larger fibroid size is associated with poorer clinical outcomes and a greater risk of complications due to more extensive collateral circulation [42][43][44]. Conversely, other reports described worse results in smaller myomas, possibly because these are mainly sustained by the collaterals surrounding the uterine walls [45][46][47], and also others found no correlation between baseline uterine dimension and percentage reduction in volume after UAE [48][49][50][51][52].…”

Section: Of 16mentioning

confidence: 98%

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Uterine Artery Embolization for the Treatment of Symptomatic Uterine Fibroids of Different Sizes: A Single Center Experience

Cappelli

Mosconi

Cocozza

et al. 2023

JPM

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The present study aimed to evaluate the clinical and radiological 1-year outcomes of uterine artery embolization (UAE) performed in a selected population of women with symptomatic myomas and who do not wish to conceive. Between January 2004 and January 2018, a total of 62 patients with pre-menopausal status and with no wish to conceive in the future underwent UAE for the treatment of symptomatic fibroids. All the patients underwent magnetic resonance imaging (MRI) and/or transvaginal ultrasonography (TV-US) before and after the procedure at 1-year follow-up. Clinical and radiological parameters were recorded, stratifying the population into 3 groups according to the size of the dominant myoma (group 1: <50 mm; group 2: ≥50 and ≤80 mm; group 3: >80 mm). Mean fibroid diameter was significantly reduced (42.6% ± 21.6%) at 1-year follow-up, with excellent improvements in terms of both symptoms and quality of life. No significant difference was observed regarding baseline dimension and the number of myomas. No major complications were reported (2.5%). The present study confirms the safety and efficacy of UAE in the treatment of symptomatic fibroids in pre-menopausal women with no desire to conceive.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Of 16mentioning

confidence: 98%

See 1 more Smart Citation

Uterine Artery Embolization for the Treatment of Symptomatic Uterine Fibroids of Different Sizes: A Single Center Experience

Cappelli

Mosconi

Cocozza

et al. 2023

JPM

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“…The choice of treatment for uterine fibroid depends largely on the clinical symptoms of the patient, but surgery is still the main treatment. Surgery is currently the most effective treatment method, including hysterectomy, laparoscopic myomectomy, hysteroscopic myomectomy, and open myomectomy, and it is the standard treatment of uterine fibroid, but it will cause some trauma to patients [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Intelligent Noise Reduction Algorithm to Evaluate the Correlation between Human Fat Deposits and Uterine Fibroids under Ultrasound Imaging

Luo

Huang

Zeng

et al. 2021

Journal of Healthcare Engineering

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This study aimed to realize the automatic diagnosis of fatty degeneration of uterine fibroids. In this study, the traditional nonlocal means (NLM) algorithm was improved by changing the Euclidean distance and introducing a cosine function and applied to the ultrasonic imaging intelligent diagnosis of patients with fatty degeneration of uterine fibroids. Then, the noise reduction effect of the improved NLM algorithm was evaluated based on several indicators, such as peak signal-to-noise ratio (PSNR), mean square error (MSE), contrast-to-noise ratio (CNR), figure of merit (FOM), and structural similarity (SSIM). The accuracy, sensitivity, specificity, and F1 score were adopted to evaluate the improved NLM algorithm for diagnosing fatty degeneration of uterine fibroids, and the Perona–Malik (PM) algorithm and NLM algorithm were used for comparative analysis. The results showed that after the ultrasound images of patients with uterine fibroids were denoised using the improved NLM algorithm, the PSNR, MSE, CNR, FOM, and SSIM were obviously better than the same indicators of the image processed with the PM algorithm and the NLM algorithm, and the differences were statistically significant ( P < 0.05 ). The diagnosis results of patients with fatty degeneration of uterine fibroids found that there was only one patient with missed diagnosis after the ultrasound image was processed with NLM algorithm, and there was no statistical difference between the improved NLM algorithm and the assisted diagnosis accuracy of the pathological examination results ( P > 0.05 ). The average noise reduction time of the PM algorithm, NLM algorithm, and the improved NLM algorithm was 16.38 ± 4.33 s, 18.01 ± 5.14 s, and 23.81 ± 4.62 s, respectively. The diagnosis rate before improvement was 75.0%, the diagnosis accuracy rate for PM was 79.69%, and that after improvement was 85.94%. In summary, the improved NLM algorithm showed a good noise reduction effect on ultrasound images of patients with uterine fibroids, could improve the diagnosis accuracy of fatty degeneration of uterine fibroids, and could assist clinicians in the ultrasound imaging diagnosis of patients with uterine fibroids.

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“…The radiomics studies has shown its advantages on the differential diagnosis of uterine fibroids ( 40 - 42 ). Kurban et al ( 41 ) collected 75 patients with 212 uterine fibroids who were successfully treated by uterine artery embolization (UAE) and developed a radiomics model of treatment response to UAE. A five-variable predictive ROC model was developed to evaluate the diagnostic accuracy of the signal intensity ratio and heterogeneity ratio on T2-weighted MRI, contrast enhancement ratio on T1-weighted MRI, location, and baseline fibroid volume.…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a radiomics model based on T2-weighted imaging for predicting the efficacy of high intensity focused ultrasound ablation in uterine fibroids

Cheng,

Yang,

Wang

et al. 2024

Quant Imaging Med Surg

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Background The heterogeneity of uterine fibroids in magnetic resonance imaging (MRI) is complex for a subjective visual evaluation, therefore it is difficult for an accurate prediction of the efficacy of high intensity focused ultrasound (HIFU) ablation in fibroids before the treatment. The purpose of this study was to set up a radiomics model based on MRI T2-weighted imaging (T2WI) for predicting the efficacy of HIFU ablation in uterine fibroids, and it would be used in preoperative screening of the fibroids for achieving high non-perfused volume ratio (NPVR). Methods A total of 178 patients with uterine fibroids were consecutively enrolled and treated with ultrasound-guided HIFU under conscious sedation between February 2017 and December 2021. Among them, 96 patients with 108 uterine fibroids with high ablation efficacy (NPVR ≥80%, h_NPVR) and 82 patients with 92 fibroids with lower ablation efficacy (NPVR <80%, l_NPVR) were retrospectively analyzed. The transverse T2WI images of fibroids were selected, and the fibroids were delineated slice by slice using ITK-SNAP software. The radiomics analysis was performed to find the imaging biomarker for the construction of a predicting model for the evaluation of the ablation efficacy, including the feature extraction, feature selection and model construction. The prediction model was built by logistic regression and assessed by receiver operating characteristic (ROC) curve, and the prediction efficiency of the two models was compared by Delong test. The ratio of the training set to the testing set was 8:2. Results The logistic regression model showed that the mean area under the curve (AUC) of the training set was 0.817 [95% confidence interval (CI): 0.755–0.882], and the testing set was 0.805 (95% CI: 0.670–0.941), respectively, which indicated a strong classification ability. The Delong test showed that there was no significant difference in the area under the ROC curve between the training set and testing set (P>0.05). Conclusions The radiomics model based on T2WI is feasible and effective for predicting the efficacy of HIFU ablation in treatment of uterine fibroids.

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Uterine Artery Embolization of Uterine Leiomyomas: Predictive MRI Features of Volumetric Response

Cited by 6 publications

References 35 publications

Uterine Artery Embolization for the Treatment of Symptomatic Uterine Fibroids of Different Sizes: A Single Center Experience

Uterine Artery Embolization for the Treatment of Symptomatic Uterine Fibroids of Different Sizes: A Single Center Experience

Intelligent Noise Reduction Algorithm to Evaluate the Correlation between Human Fat Deposits and Uterine Fibroids under Ultrasound Imaging

Development and validation of a radiomics model based on T2-weighted imaging for predicting the efficacy of high intensity focused ultrasound ablation in uterine fibroids

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