Uterine fibroid embolization can still be improved: observations on post-procedure magnetic resonance imaging

Dorenberg, Eric; Novaković, Zorica; Smith, H.-J.; Hafsahl, Geir; Jakobsen, Jarl Å.

doi:10.1080/02841850510021706

Cited by 14 publications

(10 citation statements)

References 15 publications

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“…Furthermore, MR can depict whether there is a reduction in vascularity of a fibroleiomyomata after UAE, and thus assess the vascular supply [7] . Also, MR-imaging can indicate a hemorrhagic infarction and thereby assess the effectiveness of the therapy [12] .…”

Section: Discussionmentioning

confidence: 99%

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CT-monitored percutaneous cryoablation of uterine fibroids after uterine artery embolization

Zhao

Guo

et al. 2007

Chin. J. Clin. Oncol.

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OBJECTIVE To investigate the effects of percutaneous cryoablation on uterine fibroids using computed tomographic (CT) guidance after uterine artery embolization. METHODS Twelve patients who failed to respond to uterine artery embolization were treated using percutaneous cryoablation. All patients had undergone previous uterine artery embolization an average of 1.2 years (0.7~1.6 years) ago. Two cases had abnormal bleeding, and the other 10 suffered from pressure and/or pelvic pain. Myoma diameters were 4 cm to 16.5 cm. By using CT guidance, 2.0, 2.4, 3.0 or 3.8 mm cryoprobes were placed into the fibroid, and two 15~20 min freezing processes were performed. Hemostasis was achieved only by pressing the incisions for several minutes. MR-imaging was performed before the procedure to measure the size and number of fibroid tumors, and follow-up MR-imaging determined the reduction of the lesions. RESULTS All patients were discharged within 48 h of treatment. Almost no hemorrhage was found in all of the cases. No bladder or bowel injury or significant postsurgery pain was reported. Ice spheres were readily visualized at CT. Beam-hardening artifact from the metal probes was present, but did not interfere with the procedure. Myomas regressed up to 76.3% after 12 months of treatment, and the primary symptoms improved in all treated women. CONCLUSION CT-monitored percutaneous cryoablation is an effective and minimally invasive therapy for symptom relief and fibroid shrinkage after the failure of uterine artery embolization.

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Section: Discussionmentioning

confidence: 99%

“…UAE is an intervention that is es- Percutaneous cryoablation has been successfully used to treat the lesions of the liver, kidneys, prostate, thorax and other kinds of cancers [5][6][7] . However, owing to the concern that large probes can cause bleeding when removed, experience is limited in percutaneous cryoablation of uterine fibroids.…”

Section: Discussionmentioning

confidence: 99%

CT-monitored percutaneous cryoablation of uterine fibroids after uterine artery embolization

Zhao

Guo

et al. 2007

Chin. J. Clin. Oncol.

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“…Investigators found incomplete embolization in 20% of cases despite indications by angiography of complete occlusion. They also found that incomplete embolization of uterine fibroids has led to tumor recurrence and persistence of symptoms [32] , while exceeding the endpoint by injecting too much embolic material increases the chances of uterine damage [31] . Until recently, there has been no noninvasive technique to track/map the distribution of embolic materials after intervention, which represents a significant disadvantage.…”

Section: Body Interventionsmentioning

confidence: 99%

Value of MR contrast media in image-guided body interventions

Saeed¹

2012

WJR

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In the past �ew years, there have been multiple advances in magnetic resonance (MR) instrumentation, in vivo devices, real-time imaging sequences and interventional procedures with new therapies. More recently, interventionists have started to use minimally invasive image-guided procedures and local therapies, which reduce the pain �rom conventional surgery and increase drug e��ectiveness, respectively. Local therapy also reduces the systemic dose and eliminates the toxic side e��ects o� some drugs to other organs. The success o� MR-guided procedures depends on visualization o� the targets in 3D and precise deployment o� ablation catheters, local therapies and devices. MR contrast media provide a wealth o� tissue contrast and allows 3D and 4D image acquisitions. A�ter the development o� �ast imaging sequences, the clinical applications o� MR contrast media have been substantially expanded to include pre-during-and post-interventions. �rior to intervention, MR contrast media have the potential to localize and delineate pathologic tissues o� vital organs, such as the brain, heart, breast, kidney, prostate, liver and uterus. They also o��er other options such as labeling therapeutic agents or cells. During intervention, these agents have the capability to map blood vessels and enhance the contrast between the endovascular guidewire/catheters/devices, blood and tissues as well as direct therapies to the target. Furthermore, labeling therapeutic agents or cells aids in visualizing their delivery sites and tracking their tissue distribution. A�ter intervention, MR contrast media have been used �or assessing the efficacy of ablation and therapies. It should be noted that most image-guided procedures are under preclinical research and development. It can be concluded that MR contrast media have great value in preclinical and some clinical interventional procedures. Future applications o� MR contrast media in image-guided procedures depend on their sa�ety, tolerability, tissue speci�icity and e��ectiveness in demonstrating success o� the interventions and therapies.

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“…Tumor reduction alleviates the bulk‐related symptoms or bleeding from uterine fibroids and allows subsequent treatment or removal of the malignant tumors (5, 6). Traditionally, angiographic techniques are used to guide a catheter to the tumor and embolization is performed until an endpoint of stasis or near stasis of antegrade blood flow is reached as determined by indirect visual assessment using an iodinated blood pool contrast agent (2, 7).…”

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confidence: 99%

Modification of embolic‐PVA particles with MR contrast agents

Cilliers

Song

Kohlmeir

et al. 2008

Magnetic Resonance in Med

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Uterine fibroid embolization can still be improved: observations on post-procedure magnetic resonance imaging

Abstract: UFE causes significant volume reduction of myomas and clinical improvement. MRI can reveal remaining vascularization in myomas despite angiographically complete embolization of uterine arteries.

Cited by 14 publications

References 15 publications

CT-monitored percutaneous cryoablation of uterine fibroids after uterine artery embolization

CT-monitored percutaneous cryoablation of uterine fibroids after uterine artery embolization

Value of MR contrast media in image-guided body interventions

Modification of embolic‐PVA particles with MR contrast agents

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