| 1. Goodwin SC, Spies JB. Uterine fibroid embolization. N Engl J Med 2009;361:690-7. |
Review/Other-Dx |
1 patient |
To review a case of uterine fibroid embolization. |
No results stated in abstract. |
4 |
| 2. Baird DD, Dunson DB, Hill MC, Cousins D, Schectman JM. High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. Am J Obstet Gynecol 2003;188:100-7. |
Observational-Dx |
1364 women |
To estimate the age-specific proportion of black and white women in whom fibroid tumors develop. |
Thirty-five percent of premenopausal women had a previous diagnosis of fibroid tumors. Fifty-one percent of the premenopausal women who had no previous diagnosis had ultrasound evidence of fibroid tumors. The estimated cumulative incidence of tumors by age 50 was >80% for black women and nearly 70% for white women. The difference between the age-specific cumulative incidence curves for black and white women was highly significant (odds ratio, 2.9; 95% CI, 2.5-3.4; P <.001). |
4 |
| 3. Stewart EA. Clinical practice. Uterine fibroids. N Engl J Med 2015;372:1646-55. |
Review/Other-Dx |
1 patient |
To evaluate a case report of a woman with heavy menstrual bleeding. |
No results stated in abstract. |
4 |
| 4. Walker CL, Stewart EA. Uterine fibroids: the elephant in the room. Science 2005;308:1589-92. |
Review/Other-Dx |
N/A |
To review uterine fibroids. |
No results stated in abstract. |
4 |
| 5. Alexander AL, Strohl AE, Rieder S, Holl J, Barber EL. Examining Disparities in Route of Surgery and Postoperative Complications in Black Race and Hysterectomy. Obstet Gynecol 2019;133:6-12. |
Review/Other-Dx |
15136 patients |
To estimate the associations among race, route of hysterectomy, and postoperative complications among women undergoing hysterectomy for benign indications. |
Of 15,136 women who underwent hysterectomy for benign indications, 75% were white and 25% were black. Black women were more likely to undergo an open hysterectomy than white women (50.1% vs 22.9%; odds ratio [OR] 3.36, 95% CI 3.11-3.64). Black women had larger uteri (median 262 g vs 123 g; 60.7% vs 25.6% with uterus greater than 250 g), more prior pelvic surgery (58.5% vs 53.2%), and higher body mass indices (32.7 vs 30.4). After adjusting for these and other clinical factors, black women remained more likely to undergo an open hysterectomy (adjusted OR 2.02, 95% CI 1.85-2.20). Black women experienced more major complications than white women (4.1% vs 2.3%; P<.001) and more minor complications (11.4% vs 6.7%; OR 1.78, P<.001). Again these disparities persisted with adjustment (major adjusted OR 1.56, 95% CI 1.25-1.95; minor adjusted OR 1.27, 95% CI 1.11-1.47). |
4 |
| 6. Laughlin-Tommaso SK, Jacoby VL, Myers ER. Disparities in Fibroid Incidence, Prognosis, and Management. [Review]. Obstet Gynecol Clin North Am. 44(1):81-94, 2017 Mar. |
Review/Other-Dx |
N/A |
To discuss health disparities in fibroid incidence and management. |
No results stated in abstract. |
4 |
| 7. Cardozo ER, Clark AD, Banks NK, Henne MB, Stegmann BJ, Segars JH. The estimated annual cost of uterine leiomyomata in the United States. Am J Obstet Gynecol 2012;206:211 e1-9. |
Review/Other-Dx |
N/A |
To estimate the total annual societal cost of uterine fibroid tumors in the United States, based on direct and indirect costs that include associated obstetric complications. |
The estimated annual direct costs (surgery, hospital admissions, outpatient visits, and medications) were $4.1-9.4 billion. Estimated lost work-hour costs ranged from $1.55-17.2 billion annually. Obstetric outcomes that were attributed to fibroid tumors resulted in a cost of $238 million to $7.76 billion annually. Uterine fibroid tumors were estimated to cost the United States $5.9-34.4 billion annually. |
4 |
| 8. Manyonda I, Belli AM, Lumsden MA, et al. Uterine-Artery Embolization or Myomectomy for Uterine Fibroids. N Engl J Med. 383(5):440-451, 2020 07 30. |
Observational-Tx |
254 women |
To evaluate myomectomy, as compared with uterine-artery embolization, in women who had symptomatic uterine fibroids and did not want to undergo hysterectomy. |
Data on the primary outcome were available for 206 women (81%). In the intention-to-treat analysis, the mean (+/-SD) score on the health-related quality-of-life domain of the UFS-QOL questionnaire at 2 years was 84.6+/-21.5 in the myomectomy group and 80.0+/-22.0 in the uterine-artery embolization group (mean adjusted difference with complete case analysis, 8.0 points; 95% confidence interval [CI], 1.8 to 14.1; P = 0.01; mean adjusted difference with missing responses imputed, 6.5 points; 95% CI, 1.1 to 11.9). Perioperative and postoperative complications from all initial procedures, irrespective of adherence to the assigned procedure, occurred in 29% of the women in the myomectomy group and in 24% of the women in the uterine-artery embolization group. |
4 |
| 9. Lee C, Salim R, Ofili-Yebovi D, Yazbek J, Davies A, Jurkovic D. Reproducibility of the measurement of submucous fibroid protrusion into the uterine cavity using three-dimensional saline contrast sonohysterography. Ultrasound Obstet Gynecol 2006;28:837-41. |
Observational-Dx |
33 patients |
To determine the intraobserver and interobserver reproducibility of measurement of the percentage of protrusion of submucous fibroids into the uterine cavity using three-dimensional saline contrast sonohysterography (3D-SCSH). |
There was a good agreement between the observers in classifying the fibroids as greater or less than 50% confined to the myometrium (Cohen's kappa 0.81). There was no bias in measurements for both variables either between observers or with repeated measurements by each observer. For fibroid diameter and protrusion ratio the inter- and intraclass correlation coefficients were high (0.984-0.995), with narrow limits of agreement. |
4 |
| 10. Salim R, Lee C, Davies A, Jolaoso B, Ofuasia E, Jurkovic D. A comparative study of three-dimensional saline infusion sonohysterography and diagnostic hysteroscopy for the classification of submucous fibroids. Hum Reprod 2005;20:253-7. |
Observational-Dx |
49 patients |
To compare three-dimensional saline infusion sonohysterography (3D SIS) and diagnostic hysteroscopy for the diagnosis and classification of submucous uterine fibroids. |
Diagnostic hysteroscopy confirmed these findings in all cases. There was agreement between the two methods in 11/12 cases of Type 0 fibroids (92%), 34/37 (92%) of Type I fibroids and 9/12 (75%) of Type II fibroids. The overall level of agreement was good with a kappa value of 0.80. |
3 |
| 11. Sabry ASA, Fadl SA, Szmigielski W, et al. Diagnostic value of three-dimensional saline infusion sonohysterography in the evaluation of the uterus and uterine cavity lesions. Pol J Radiol 2018;83:e482-e90. |
Review/Other-Dx |
216 patients |
To illustrate and discuss the seldom used technique of three-dimensional (3D) saline infusion sonohysterography (SIS) based on instillation of sterile saline through a catheter into the uterus under real-time vaginal transducer observation for assessment of the endometrial cavity. |
The review presents the most common indication for SIS, like abnormal bleeding in pre- and postmenopausal patients. SIS allows us to distinguish between focal lesions and global endometrial thickening. SIS should be supported as a second-line diagnostic procedure for abnormal uterine bleeding, when findings from transvaginal ultrasound are inconclusive. |
4 |
| 12. Davis PC, O'Neill MJ, Yoder IC, Lee SI, Mueller PR. Sonohysterographic findings of endometrial and subendometrial conditions. Radiographics 2002;22:803-16. |
Review/Other-Dx |
N/A |
To review sonohysterographic findings of endometrial and subendometrial conditions. |
No results stated in abstract. |
4 |
| 13. Ong CL. The current status of three-dimensional ultrasonography in gynaecology. Ultrasonography 2016;35:13-24. |
Review/Other-Dx |
N/A |
To review the current status of three-dimensional ultrasonography in gynaecology. |
No results stated in abstract. |
4 |
| 14. Grigore M, Pristavu A, Iordache F, Gafitanu D, Ursulescu C. Comparative Study of Hysteroscopy and 3D Ultrasound for Diagnosing Uterine Cavity Abnormalities. Rev Med Chir Soc Med Nat Iasi. 120(4):866-73, 2016 Oct-Dec. |
Observational-Dx |
139 patients |
To compare the accuracy of three-dimensional (3D) ultrasonography and hysteroscopy in identifying uterine cavity abnormalities. |
Mean patients' age was 36.5 (+/- SD 9.04). Three-dimensional ultrasound had a sensitivity of 88%, specificity of 94%, a positive predictive value of 96%, negative predictive value of 84%, likely ratio of 5,5, and accuracy of 90% in diagnosing uterine cavity abnormalities. Three-dimensional ultrasound had a high sensitivity and specificity for polyps (97% and 97%, respectively), congenital uterine malformations (100% and 99%, respectively) and submucous myoma (87% and 100%, respectively), but a low sensitivity and high specificity for uterine synechia (41% and 99%, respectively). |
3 |
| 15. Keizer AL, Nieuwenhuis LL, Twisk JWR, Huirne JAF, Hehenkamp WJK, Brolmann HAM. Role of 3-Dimensional Sonography in the Assessment of Submucous Fibroids: A Pilot Study. J Ultrasound Med. 37(1):191-199, 2018 Jan. |
Observational-Dx |
14 patients |
To investigate the accuracy and reliability of 3-dimensional (3D) transvaginal sonography in classifying submucous fibroids using the International Federation of Gynecology and Obstetrics PALM-COEIN (polyp, adenomyosis, leiomyoma, malignancy and hyperplasia, coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, and not yet classified) classification and protrusion (percent) compared to 2-dimensional (2D) transvaginal sonography, 2D saline infusion sonography, and 3D saline infusion sonography, using hysteroscopy as a reference test. |
The intraclass correlation coefficient (ICC) for 2D transvaginal sonography versus hysteroscopy was 0.69 (95% confidence interval [CI], 0.06, 0.90) compared to 0.94 (95% CI, 0.83, 0.98) for 2D saline infusion sonography. The ICCs for 3D transvaginal sonography versus hysteroscopy were 0.69 (95% CI, 0.03, 0.90 [investigator A]) and 0.55 (95% CI, -0.48, 0.86 [investigator B]). The ICCs for 3D saline infusion sonography versus hysteroscopy were 0.94 (95% CI, 0.81, 0.98 [investigator A]) and 0.87 (95% CI, 0.60, 0.96 [investigator B]). Interobserver agreement of 3D transvaginal sonography was 0.81 (95% CI, 0.43, 0.94) compared to 0.86 (95% CI, 0.56, 0.96) for 3D saline infusion sonography. |
2 |
| 16. Frank ML, Schafer SD, Mollers M, et al. Importance of Transvaginal Elastography in the Diagnosis of Uterine Fibroids and Adenomyosis. Ultraschall in der Medizin. 37(4):373-8, 2016 Aug. |
Observational-Dx |
206 patients |
To evaluate normal uterine tissue with special regard to age and the presence of uterine fibroids and adenomyosis with transvaginal elastography. |
The "age index" was significantly negatively correlated with the age of the women (r = -0.49, p < 0.001). The median "lesion indices" were significantly (p < 0.001) different between the uterine fibroid, adenomyosis and control groups. Median "lesion indices" were 2.65, 0.44 and 1.19, respectively. |
3 |
| 17. Zhang M, Wasnik AP, Masch WR, et al. Transvaginal Ultrasound Shear Wave Elastography for the Evaluation of Benign Uterine Pathologies: A Prospective Pilot Study. Journal of Ultrasound in Medicine. 38(1):149-155, 2019 Jan.J Ultrasound Med. 38(1):149-155, 2019 Jan. |
Observational-Dx |
34 patients |
To evaluate the diagnostic performance of transvaginal ultrasound (TVUS) shear wave elastography (SWE) for evaluating uterine adenomyosis and leiomyomas. |
Continuous variables were analyzed using means, t tests, and analysis of variance. Magnetic resonance imaging revealed adenomyosis in 6 women (12 uterine segments) and leiomyomas in 12 women (28 segments). On a per-patient basis, mean SWV in 16 women with no adenomyosis or leiomyoma was 4.3 +/- 1.7 m/s, compared with 5.7 +/- 2.3 m/s in 18 women with a magnetic resonance diagnosis of myometrial pathology (P < .0002; 95% confidence interval, -2.2, -0.6). On a per-segment basis, SWV in normal myometrium was 4.8 +/- 1.9 m/s, compared with 4.9 +/- 2.5 m/s in adenomyosis and 5.6 +/- 2.5 m/s in leiomyoma (P = .34 by one-way analysis of variance). In pairwise comparison, SWV for adenomyosis and leiomyoma did not differ significantly (P = .40). |
2 |
| 18. Stoelinga B, Hehenkamp WJK, Nieuwenhuis LL, et al. Accuracy and Reproducibility of Sonoelastography for the Assessment of Fibroids and Adenomyosis, with Magnetic Resonance Imaging as Reference Standard. Ultrasound Med Biol. 44(8):1654-1663, 2018 08. |
Review/Other-Dx |
N/A |
To estimate the inter-observer agreement and reproducibility of real-time sonoelastography and real-time gray-scale ultrasound in the measurement of uterine and fibroid volumes; (ii) to evaluate the agreement between real-time gray-scale ultrasound, sonoelastography and magnetic resonance imaging with respect to these outcomes; and (iii) to evaluate the diagnostic accuracy of sonoelastography in the diagnosis of uterine pathology on stored sonoelastography and gray-scale cine loops. |
No results stated in abstract. |
4 |
| 19. Stoelinga B, Hehenkamp WJ, Brolmann HA, Huirne JA. Real-time elastography for assessment of uterine disorders. Ultrasound Obstet Gynecol. 43(2):218-26, 2014 Feb. |
Review/Other-Dx |
218 Women |
To define, in a systematic manner, specific sonoelastographic characteristics of the myometrium, fibroids and adenomyosis, to evaluate the feasibility of sonoelastography in patients with suspected gynecological pathology and to compare the results with histology and/or magnetic resonance imaging (MRI)-based diagnoses. |
With elastography, the uterus was well delineated from the surrounding bowel. The myometrium was uniform in color in 49% of the cases, with a main color of purple or dark blue, indicating stiffer tissue. Fibroids and adenomyosis had different elastographic characteristics and different color patterns. In general, fibroids were darker and adenomyosis was brighter than adjacent myometrium. The agreement between elastography-based diagnosis of fibroids and adenomyosis with MRI-based diagnosis was excellent; with histology-based diagnosis, agreement was substantial for fibroids and adenomyosis. |
4 |
| 20. Lakhman Y, Veeraraghavan H, Chaim J, et al. Differentiation of Uterine Leiomyosarcoma from Atypical Leiomyoma: Diagnostic Accuracy of Qualitative MR Imaging Features and Feasibility of Texture Analysis. European Radiology. 27(7):2903-2915, 2017 Jul. |
Observational-Dx |
41 Women |
To investigate whether qualitative magnetic resonance (MR) features can distinguish leiomyosarcoma (LMS) from atypical leiomyoma (ALM) and assess the feasibility of texture analysis (TA). |
Four qualitative MR features most strongly associated with LMS were nodular borders, haemorrhage, "T2 dark" area(s), and central unenhanced area(s) (p?=?0.0001 each feature/reader). The highest sensitivity [1.00 (95%CI:0.82-1.00)/0.95 (95%CI: 0.74-1.00)] and specificity [0.95 (95%CI:0.77-1.00)/1.00 (95%CI:0.85-1.00)] were achieved for R1/R2, respectively, when a lesion had =3 of these four features. Sixteen texture features differed significantly between LMS and ALM (p-values: <0.001-0.036). Unsupervised clustering achieved accuracy of 0.75 (sensitivity: 0.70; specificity: 0.79). |
2 |
| 21. Hossain MZ, Rahman MM, Ullah MM, et al. A Comparative Study of Magnetic Resonance Imaging and Transabdominal Ultrasonography for the Diagnosis and Evaluation of Uterine Fibroids. Mymensingh Medical Journal: MMJ. 26(4):821-827, 2017 Oct.Mymensingh Med J. 26(4):821-827, 2017 Oct. |
Observational-Dx |
40 patients |
To compare and evaluate the usefulness of MRI and transabdominal ultrasonography for the diagnosis of uterine fibroids. |
In the diagnosis of uterine fibroids, USG was 88.2% sensitive, 66.7% specific, 85.0% accurate, 93.8% positive predictive values and 50% negative predictive values. However MRI was 97.1% sensitive, 83.3% specific, 95.0% accurate, 97.1% positive predictive values and 83.3% negative predictive values for prediction of uterine fibroids. |
2 |
| 22. Battista C, Capriglione S, Guzzo F, et al. The challenge of preoperative identification of uterine myomas: Is ultrasound trustworthy? A prospective cohort study. Arch Gynecol Obstet. 293(6):1235-41, 2016 06. |
Observational-Dx |
126 patients |
To correlate preoperative ultrasound examination with intraoperative and anatomo-pathological findings, including estimation of number, localization and size of uterine myomas, uterine diameters and volume. |
There was no significant difference between the number of myomas recorded at visualization and at ultrasound, while there was a significant difference between visualization and anatomo-pathology (p = 0.0006). The analysis showed a non-significant difference between myoma number at ultrasound and at anatomo-pathology in the two groups, if the number of myomas was less than or equal to six. Contrarily, we observed a significant difference if the number of myomas was more than six (p = 0.003). |
3 |
| 23. Malartic C, Morel O, Rivain AL, et al. Evaluation of symptomatic uterine fibroids in candidates for uterine artery embolization: comparison between ultrasonographic and MR imaging findings in 68 consecutive patients. Clin Imaging. 37(1):83-90, 2013 Jan-Feb. |
Observational-Dx |
68 patients |
To determine whether MR imaging may alter the therapeutic approach based on ultrasonography alone before uterine embolization. |
Discordant findings between both examinations involved 51 women (75%), and 19 (28%) had their therapeutic approaches based on ultrasonography alone altered by MR imaging. Ultrasonography and MR imaging showed concordant findings in 17 women (25%) for whom no changes in therapeutic option were made. |
3 |
| 24. Rajan DK, Margau R, Kroll RR, et al. Clinical utility of ultrasound versus magnetic resonance imaging for deciding to proceed with uterine artery embolization for presumed symptomatic fibroids. Clin Radiol. 66(1):57-62, 2011 Jan. |
Observational-Dx |
180 patients |
To compare the diagnostic utility of pelvic ultrasound (US) and magnetic resonance imaging (MRI) on the clinical decision to proceed with uterine artery embolization (UAE). |
For the 116 patients who completed imaging, the average uterine volume was 701 cm(3) using MRI versus 658 cm(3) using US (p=0.48). The average dominant leiomyoma volume was 292 cm(3) using MRI versus 253 cm(3) using US (p=0.16). In 14 (12.1%) patients US did not correctly quantify or localize leiomyomas compared with MRI (p=0.0005). Thirteen patients did not undergo UAE (patient preference n=9, pre-procedural imaging findings n=4). In the four cases where UAE was not performed due to imaging findings, relevant findings were all diagnosed by MRI compared with two by US (p=0.5). The two cases not detected by ultrasound were adenomyosis and a pedunculate subserosal leiomyoma. Of the 103 patients who underwent UAE, 14 were treated (without complication) despite the presence of a relative contraindication; all 14 relative contraindications were identified by MRI compared with 13 by US (p=1.0). |
3 |
| 25. Kirby JM, Burrows D, Haider E, Maizlin Z, Midia M. Utility of MRI before and after uterine fibroid embolization: why to do it and what to look for. [Review]. Cardiovasc Intervent Radiol. 34(4):705-16, 2011 Aug. |
Review/Other-Dx |
N/A |
To review the utility of MRI before and after uterine fibroid embolization |
No results stated in abstract. |
4 |
| 26. Kubik-Huch RA, Weston M, Nougaret S, et al. European Society of Urogenital Radiology (ESUR) Guidelines: MR Imaging of Leiomyomas. Eur Radiol. 28(8):3125-3137, 2018 Aug. |
Review/Other-Dx |
25 questionnaires |
To develop imaging guidelines for MR work-up in patients with known or suspected uterine leiomyomas. |
The 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. |
4 |
| 27. American College of Radiology. ACR Committee on Drugs and Contrast Media. Manual on Contrast Media. Available at: https://www.acr.org/-/media/ACR/Files/Clinical-Resources/Contrast_Media.pdf. |
Review/Other-Dx |
N/A |
Guidance document to assist radiologists in recognizing and managing the small but real risks inherent in the use of contrast media. |
No abstract available. |
4 |
| 28. Ueda H, Togashi K, Konishi I, et al. Unusual appearances of uterine leiomyomas: MR imaging findings and their histopathologic backgrounds. Radiographics 1999;19 Spec No:S131-45. |
Review/Other-Dx |
N/A |
To review MR imaging findings and their histopathologic backgrounds in unusual appearances of uterine leiomyomas. |
No results stated in abstract. |
4 |
| 29. Arleo EK, Schwartz PE, Hui P, McCarthy S. Review of Leiomyoma Variants. [Review]. AJR Am J Roentgenol. 205(4):912-21, 2015 Oct. |
Review/Other-Dx |
N/A |
To review the clinical, imaging, and pathologic features of leiomyoma variants. |
No results stated in abstract. |
4 |
| 30. Bolan C, Caserta MP. MR imaging of atypical fibroids. [Review]. Abdom Radiol. 41(12):2332-2349, 2016 12. |
Review/Other-Dx |
N/A |
To review imaging features of atypical leiomyoma with case-based examples. |
No results stated in abstract. |
4 |
| 31. DeMulder D, Ascher SM. Uterine Leiomyosarcoma: Can MRI Differentiate Leiomyosarcoma From Benign Leiomyoma Before Treatment?. [Review]. AJR Am J Roentgenol. 211(6):1405-1415, 2018 12. |
Review/Other-Dx |
N/A |
To provide background on the epidemiologic, clinical, and economic impact of uterine leiomyomas, summarize the concerns associated with treating women with potential occult leiomyosarcomas (LMSs), and review the known and emerging imaging features of typical and atypical leiomyomas and explain how to differentiate them from LMSs. |
No results stated in abstract. |
4 |
| 32. Barral M, Place V, Dautry R, et al. Magnetic resonance imaging features of uterine sarcoma and mimickers. [Review]. Abdom Radiol. 42(6):1762-1772, 2017 06. |
Review/Other-Dx |
N/A |
To illustrate the imaging features of uterine sarcomas and potential mimickers to make the reader more familiar with this serious condition which needs special consideration. |
No results stated in abstract. |
4 |
| 33. Gaetke-Udager K, McLean K, Sciallis AP, et al. Diagnostic Accuracy of Ultrasound, Contrast-enhanced CT, and Conventional MRI for Differentiating Leiomyoma From Leiomyosarcoma. Acad Radiol. 23(10):1290-7, 2016 10. |
Observational-Dx |
28 Patients |
To determine whether uterine leiomyoma can be distinguished from uterine leiomyosarcoma on ultrasound (US), computed tomography (CT), and/or magnetic resonance imaging (MRI) without diffusion-weighted imaging. |
Mean suspicion scores were 2.5?±?1.2 (attendings) and 2.4?±?1.3 (residents) for leiomyoma, and 2.7?±?1.3 (attendings) and 2.7?±?1.4 (residents) for leiomyosarcoma. The areas under the receiver operating characteristic curves (range: 0.330-0.685) were not significantly different from chance, either overall (P?=?.36-.88) or by any modality (P?=?.28-.96), for any reader. Reader experience had no effect on diagnostic accuracy. No morphologic parameter was significantly predictive of malignancy (P?=?.10-.97). |
3 |
| 34. Abdel Wahab C, Jannot AS, Bonaffini PA, et al. Diagnostic Algorithm to Differentiate Benign Atypical Leiomyomas from Malignant Uterine Sarcomas with Diffusion-weighted MRI. Radiology 2020;297:E347. |
Review/Other-Dx |
N/A |
To review a diagnostic algorithm to differentiate benign atypical leiomyomas from malignant uterine sarcomes with diffusion-weighted MRI. |
No results stated in abstract. |
4 |
| 35. Sun S, Bonaffini PA, Nougaret S, et al. How to differentiate uterine leiomyosarcoma from leiomyoma with imaging. [Review]. Diagn Interv Imaging. 100(10):619-634, 2019 Oct. |
Review/Other-Dx |
N/A |
To provide an overview of the differences between leiomyoma and leiomyosarcoma, mainly focusing on imaging characteristics, but also briefly touching upon their demographic, histopathological and clinical differences. |
No results stated in abstract. |
4 |
| 36. Rio G, Lima M, Gil R, Horta M, Cunha TM. T2 hyperintense myometrial tumors: can MRI features differentiate leiomyomas from leiomyosarcomas?. Abdom Radiol. 44(10):3388-3397, 2019 10. |
Observational-Dx |
41 patients |
To establish MRI features that help differentiate atypical leiomyomas and leiomyomas with degeneration that show hyperintensity on T2WI from leiomyosarcomas. |
Five MRI features demonstrated a significant correlation with malignant histology: irregular borders (p = 0.03); "T2 dark" areas (p = 0.02); presence of central necrosis (p = 0.01); presence of high signal on b1000 DWI (p < 0.001); ADC value lower than 0.82 x 10(-3) mm(2)/s; hyperenhancement of the tumor relative to the myometrium on post-contrast images (p = 0.02); and type 3 enhancing curve on DCE. Two of these features demonstrated a significant result predicting a malignant histology: lobulated contours and central necrosis [F(3;34) = 8,95; p < 0.001; R(2) = 0.506]. |
4 |
| 37. Tong A, Kang SK, Huang C, Huang K, Slevin A, Hindman N. MRI screening for uterine leiomyosarcoma. J Magn Reson Imaging 2019;49:e282-e94. |
Observational-Dx |
1960 patients |
To review the accuracy and feasibility of an interdisciplinary prospective contrast-enhanced MRI pelvis with DWI screening system for LMS prior to fibroid resection. |
We prospectively identified LMS patients with 100% sensitivity and 97% specificity. Preliminary cost analysis demonstrated that the MR screening protocol increased life expectancy by 0.04 years at a cost of $12,937 per life-year gained. |
3 |
| 38. Valdes-Devesa V, Jimenez MDM, Sanz-Rosa D, Espada Vaquero M, Alvarez Moreno E, Sainz de la Cuesta Abbad R. Preoperative diagnosis of atypical pelvic leiomyoma and sarcoma: the potential role of diffusion-weighted imaging. J Obstet Gynaecol. 39(1):98-104, 2019 Jan. |
Observational-Dx |
17 patients |
To determine the utility of diffusion-weighted magnetic resonance (DWMR) to differentiate the atypical uterine leiomyomas and sarcomas, establishing a cut-off value of the apparent diffusion coefficient (ADC) to rule out the malignancy. |
We demonstrated a consistent relationship between dichotomised ADC values in leiomyomas/sarcomas for these particular cases and in recurrent tumours, with no overlap between both the groups, as a difference with the previous reports. |
4 |
| 39. Thomassin-Naggara I, Dechoux S, Bonneau C, et al. How to differentiate benign from malignant myometrial tumours using MR imaging. Eur Radiol. 23(8):2306-14, 2013 Aug. |
Observational-Dx |
51 patients |
To retrospectively evaluate the ability of magnetic resonance imaging (MRI) to differentiate malignant from benign myometrial tumours. |
The significant criteria for prediction of malignancy were high b 1,000 signal intensity (OR = +infinity), intermediate T2-weighted signal intensity (OR = +infinity), mean ADC (OR = 25.1), patient age (OR = 20.1), intra-tumoral haemorrhage (OR = 21.35), endometrial thickening (OR = 11), T2-weighted signal heterogeneity (OR = 10.2), menopausal status (OR = 9.7), heterogeneous enhancement (OR = 8) and non-myometrial origin on MRI (OR = 4.9). In the recursive partitioning model, using b 1,000 signal intensity, T2 signal intensity, mean ADC, and patient age, the model correctly classified benign and malignant tumours in 47 of the 51 cases (92.4 %). |
3 |
| 40. Lin G, Yang LY, Huang YT, et al. Comparison of the diagnostic accuracy of contrast-enhanced MRI and diffusion-weighted MRI in the differentiation between uterine leiomyosarcoma / smooth muscle tumor with uncertain malignant potential and benign leiomyoma. J Magn Reson Imaging. 43(2):333-42, 2016 Feb. |
Observational-Dx |
8 LMS/STUMP and 25 benign leiomyomas |
To compare the diagnostic accuracy of contrast-enhanced (CE) magnetic resonance imaging (MRI) and diffusion-weighted MRI (DWI) in the differentiation between uterine leiomyosarcoma (LMS) / smooth muscle tumor with uncertain malignant potential (STUMP) and benign leiomyoma. |
CE-MRI yielded a significantly superior diagnostic accuracy (0.94 vs. 0.52) and a significantly higher specificity (0.96 vs. 0.36) than DWI (P < 0.05 for both), and remained a comparably high sensitivity as DWI (0.88 vs. 1.00). A combination of DWI and ADC value <1.08 × 10(-3) mm2 /s (determined by receiver operating characteristic analysis) improved diagnostic accuracy, sensitivity, and specificity of DWI to 0.88, 0.88, and 0.88, respectively, by post-hoc analysis based on the same study cohort. |
3 |
| 41. Siddiqui N, Nikolaidis P, Hammond N, Miller FH. Uterine artery embolization: pre- and post-procedural evaluation using magnetic resonance imaging. [Review]. Abdom Imaging. 38(5):1161-77, 2013 Oct. |
Review/Other-Dx |
N/A |
To demonstrate the use of MR in the selection of patients, anatomic evaluation and procedural planning before UAE, describe the use of MR in evaluating treatment response after UAE and illustrate the use of MR in identifying post-UAE complications. |
No results stated in abstract. |
4 |
| 42. Yang Q, Zhang LH, Su J, Liu J. The utility of diffusion-weighted MR imaging in differentiation of uterine adenomyosis and leiomyoma. Eur J Radiol. 79(2):e47-51, 2011 Aug. |
Observational-Dx |
39 patients |
To investigate the value of diffusion-weighted MR imaging (DWI), especially apparent diffusion coefficient (ADC) in the differentiation of uterine adenomyosis and leiomyoma. |
For high signal intensive foci within the lesions, uterine adenomyosis demonstrated significantly lower mean ADC value than uterine leiomyoma (1.582 vs. 2.122 x 10(-3)mm(2)/s, P=0.001). For lesion tissues, uterine adenomyosis demonstrated significantly higher mean ADC value than uterine leiomyoma (1.214 vs. 0.967 x 10(-3)mm(2)/s, P=0.001). However, there was overlap between uterine adenomyosis and leiomyoma in both measurements. Mean ADC D-value was significantly lower in uterine adenomyosis than in uterine leiomyoma (0.369 vs. 1.096 x 10(-3)mm(2)/s, P=0.000). ADC D-value had no overlap between uterine adenomyosis and leiomyoma. |
4 |
| 43. De La Cruz MS, Buchanan EM. Uterine Fibroids: Diagnosis and Treatment. [Review]. Am Fam Physician. 95(2):100-107, 2017 Jan 15. |
Review/Other-Dx |
N/A |
To review diagnosis and treatment of uterine fibroids. |
No results stated in abstract. |
4 |
| 44. Testa AC, Di Legge A, Bonatti M, Manfredi R, Scambia G. Imaging techniques for evaluation of uterine myomas. Best Pract Res Clin Obstet Gynaecol. 34:37-53, 2016 Jul. |
Review/Other-Dx |
N/A |
To review imaging techniques for evaluation of uterine myomas |
No results stated in abstract. |
4 |
| 45. Vilos GA, Allaire C, Laberge PY, Leyland N, Special C. The management of uterine leiomyomas. J Obstet Gynaecol Can 2015;37:157-78. |
Review/Other-Dx |
N/A |
To provide clinicians with an understanding of the pathophysiology, prevalence, and clinical significance of myomata and the best evidence available on treatment modalities. |
No results stated in abstract. |
4 |
| 46. Van den Bosch T, Dueholm M, Leone FP, et al. Terms, definitions and measurements to describe sonographic features of myometrium and uterine masses: a consensus opinion from the Morphological Uterus Sonographic Assessment (MUSA) group. Ultrasound Obstet Gynecol. 46(3):284-98, 2015 Sep. |
Review/Other-Dx |
N/A |
To present a consensus opinion from the Morphological Uterus Sonographic Assessment (MUSA) group regarding terms, definitions and measurements to describe sonographic features of myometrium and uterine masses. |
No results stated in abstract. |
4 |
| 47. Robbins JB, Sadowski EA, Maturen KE, et al. ACR Appropriateness Criteria® Abnormal Uterine Bleeding. J Am Coll Radiol 2020;17:S336-S45. |
Review/Other-Dx |
N/A |
Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for abnormal uterine bleeding. |
No results stated in abstract. |
4 |
| 48. Cicinelli E, Romano F, Anastasio PS, Blasi N, Parisi C, Galantino P. Transabdominal sonohysterography, transvaginal sonography, and hysteroscopy in the evaluation of submucous myomas. Obstet Gynecol 1995;85:42-7. |
Observational-Dx |
52 patients |
To assess the usefulness of transabdominal sonohysterography in the diagnosis and evaluation of submucous myomas. |
Conventional transvaginal sonography for the diagnosis of submucous myomas had a sensitivity of 90% and a specificity of 98%; the predictive values of abnormal and normal scans were 90 and 98%, respectively. Transabdominal sonohysterography had sensitivity, specificity, and predictive values of 100%, as did hysteroscopy. In all cases, the sonographic techniques measured tumor size more accurately than did hysteroscopy. The transabdominal sonohysterography measurements differed from direct evaluation by no more than 2 mm, and the hysteroscopic measurements were significantly different from those of the surgical specimens. The sonohysterographic evaluation of intrauterine growth was significantly more precise than that of the other techniques, differing from direct measurements by no more than 5-10%. Conventional transvaginal sonography failed to localize three of 11 myomas; hysteroscopy and transabdominal sonohysterography provided the exact location in all cases. |
4 |
| 49. Dueholm M, Lundorf E, Hansen ES, Ledertoug S, Olesen F. Accuracy of magnetic resonance imaging and transvaginal ultrasonography in the diagnosis, mapping, and measurement of uterine myomas. Am J Obstet Gynecol 2002;186:409-15. |
Observational-Dx |
106 patients |
To evaluate and compare the accuracy of magnetic resonance imaging and transvaginal ultrasonography in myoma diagnosis, mapping, and measurement. |
The presence of myomas was detected with the same high level of precision by both methods (magnetic resonance imaging: sensitivity, 0.99; specificity, 0.86; transvaginal ultrasonography: sensitivity, 0.99; specificity, 0.91). The mean number of correctly identified myomas was significantly higher by magnetic resonance imaging than by transvaginal ultrasonography (mean difference, 0.51 +/- 1.03; P <.001), a difference that narrowed to 0.08 +/- 0.76 (P =.60) in 26 patients with 1 to 4 myomas and uterine volumes <375 mL. Magnetic resonance imaging and transvaginal ultrasonography myoma diameter measurements had equal and high accuracies in patients with 1 to 4 myomas. |
3 |
| 50. Sharma K, Bora MK, Venkatesh BP, et al. Role of 3D Ultrasound and Doppler in Differentiating Clinically Suspected Cases of Leiomyoma and Adenomyosis of Uterus. J Clin Diagn Res. 9(4):QC08-12, 2015 Apr. |
Observational-Dx |
100 patients |
To evaluate the role of 3D Ultrasound and Doppler in differentiating clinically suspected cases of leiomyoma and adenomyosis of uterus. |
On imaging, while using morphological criteria and Doppler for diagnosing leiomyoma, it was found that "peripheral vascularity" was seen in 52 (89%) cases, which was the highest. Similarly while diagnosing adenomyosis it was, the criteria "central vascularity" was seen in 28 cases (93%) and "ill defined junctional zone in 3D ultrasound" was seen in 26 cases (86%), which was also observed to be highest. With the cut off values taken for PI,RI and Vmax, diagnosis of leiomyoma was found to be 93.4% sensitive, 95.6% specific and with a positive predictive value of 97.6% and negative predictive value of 88.6%. Diagnosis of adenomyosis showed a sensitivity of 95.6%, specificity of 93.4% and a positive predictive value of 88.6% and negative predictive value of 97.6%. Imaging dignosed the co-existence of both the conditions correctly in 8 (66%) cases. |
3 |
| 51. Bittencourt CA, Dos Santos Simoes R, Bernardo WM, et al. Accuracy of saline contrast sonohysterography in detection of endometrial polyps and submucosal leiomyomas in women of reproductive age with abnormal uterine bleeding: systematic review and meta-analysis. [Review]. Ultrasound Obstet Gynecol. 50(1):32-39, 2017 Jul. |
Meta-analysis |
5 Studies |
To analyze the diagnostic accuracy of two- (2D) and three- (3D) dimensional saline contrast sonohysterography (SCSH) in the detection of endometrial polyps and submucosal uterine leiomyomas in women of reproductive age with abnormal uterine bleeding compared with gold standard hysteroscopy. |
A total of 1398 citations were identified and five studies were included in the systematic review and meta-analysis. Pooled sensitivity and specificity of 2D-SCSH in detecting endometrial polyps were 93% (95% CI, 89–96%) and 81% (95% CI, 76–86%), respectively, with pooled LR+ of 5.41 (95% CI, 2.60–11.28) and LR– of 0.10 (95% CI, 0.06–0.17). In the detection of submucosal uterine leiomyomas, pooled sensitivity and specificity were 94% (95% CI, 89–97%) and 81% (95% CI, 76–86%), respectively, with pooled LR+ of 4.25 (95% CI, 2.20–8.21) and LR– of 0.11 (95% CI, 0.05–0.22). 2D-SCSH had good accuracy in detecting endometrial polyps and submucosal uterine leiomyomas, with areas under the SROC curves of 0.97?±?0.02 and 0.97?±?0.03, respectively. Studies that analyzed the diagnostic accuracy of 3D-SCSH could not be compared due to high heterogeneity related to menopausal status, type of technique used and primary outcome being investigation of infertility. |
Good |
| 52. Idowu BM, Ibitoye BO. Doppler sonography of perifibroid and intrafibroid arteries of uterine leiomyomas. Obstet Gynecol Sci 2018;61:395-403. |
Observational-Dx |
140 patients |
To sonographically evaluate the dominant fibroid nodule vascularity and flow velocity pattern of perifibroid and intrafibroid arteries. |
The median volume of the dominant leiomyoma nodule was 133 cm(3) (range=1.5-2,575 cm(3)). Eighty-three subjects (59.3%) had a dominant leiomyoma nodule volume of </=200.0 cm(3) while the volume of the dominant leiomyoma nodule was >200.0 cm(3) in 57 (40.7%) subjects. The dominant fibroid nodule was vascular in 137 (97.9%) subjects and avascular in 3 (2.1%). All the perifibroid artery indices (except the end-diastolic velocity [EDV] and diastolic average ratio [DAR]) are significantly higher than those of the intrafibroid artery. The mean Doppler indices of perifibroid vs. intrafibroid arteries as follows: peak systolic velocity (PSV; 52.1 vs. 45.4 cm/s); EDV (21.1 vs. 22.4 cm/s); time-averaged maximum velocity (TAMX; 31.5 vs. 30.4 cm/s); time- averaged mean velocity (Tmean; 14.3 vs. 13.8 cm/s); pulsatility index (PI; 1.1 vs. 0.8); resistive index (RI; 0.6 vs. 0.5); systolic-diastolic ratio (SDR; 2.7 vs. 2.1); impedance index (ImI; 2.7 vs. 2.1); and DAR (0.66 vs. 0.74); P<0.001 for all indices. |
3 |
| 53. Kim SH, Sim JS, Seong CK. Interface vessels on color/power Doppler US and MRI: a clue to differentiate subserosal uterine myomas from extrauterine tumors. J Comput Assist Tomogr 2001;25:36-42. |
Observational-Dx |
68 patients |
To assess the usefulness of demonstrating these vessels in differentiating subserosal myomas from extrauterine tumors on color or power Doppler US (CDUS/PDUS) and MRI. |
The interface vessels were demonstrated in 39 of 41 subserosal myomas (18 on CDUS/PDUS, 14 on MRI, 7 on both), whereas they were seen in only 3 of 27 extrauterine tumors (1 on CDUS/PDUS, 2 on MRI). These three extrauterine tumors were ovarian malignancies that directly invaded the uterus. The shapes of these interface vessels were 7 intervening, 12 crossing, and 20 mixed in the myoma group, whereas they were mixed in all three extrauterine tumor groups. The sensitivity/specificity of this finding in differentiating subserosal myomas and extrauterine tumors was 100/92%, 91/91%, and 95/89%, respectively, with CDUS/PDUS, MRI, and either CDUS/PDUS or MRI. |
4 |
| 54. Madan R. The bridging vascular sign. Radiology 2006;238:371-2. |
Review/Other-Dx |
N/A |
To review imaging in uterine vascular myomas. |
No results stated in abstract. |
4 |
| 55. Kurjak A, Kupesic-Urek S, Miric D. The assessment of benign uterine tumor vascularization by transvaginal color Doppler. Ultrasound Med Biol 1992;18:645-9. |
Review/Other-Dx |
N/A |
To review the assessment of benign uterine tumor vascularization by transvaginal color Doppler. |
No results stated in abstract. |
4 |
| 56. Sladkevicius P, Valentin L, Marsal K. Transvaginal Doppler examination of uteri with myomas. J Clin Ultrasound 1996;24:135-40. |
Observational-Dx |
45 patients |
To study the examination of uteri of myomas with transvaginal Doppler. |
The respective median time-averaged maximum velocity and pulsatility index (PI) values for the left uterine artery were 36.1 cm/s and 1.36 in premenopausal women with myomas vs. 17.6 cm/s and 2.58 in controls; p = 0.0001. The corresponding values in postmenopausal women were 13.9 cm/s and 1.93 vs. 11.0 cm/s and 2.33; p < 0.05. PI values < 1.0 were recorded from 92% (24/26) of the myomas in premenopausal women and from 69% (11/16) of those in postmenopausal women. |
4 |
| 57. Kabil Kucur S, Temizkan O, Atis A, et al. Role of endometrial power Doppler ultrasound using the international endometrial tumor analysis group classification in predicting intrauterine pathology. Archives of Gynecology & Obstetrics. 288(3):649-54, 2013 Sep. |
Observational-Dx |
97 Patients |
To assess the contribution of the terms and definitions recently described by international endometrial tumor analysis (IETA) group when evaluating endometrial lesions on power Doppler imaging. |
Ninety-seven patients were included in the study. The histopathological diagnoses were as follows: endometrial polyp: 39 cases (40.2 %), endometrial hyperplasia: 9 cases (9.3 %), submucous myoma: 10 cases (10.3 %), endometrium cancer: 7 cases (7.2 %), non-specific findings: 32 cases (33 %). The sensitivity, specificity and positive and negative predictive values for single dominant or branching single dominant vessel pattern in diagnosing endometrial polyps were 66.67, 98.28, 96.3 and 81.43 %; for multiple vessels with focal origin pattern in diagnosing endometrial cancer, they were 42.86, 91.11, 27.27 and 95.35 %; for multifocal origin at the myometrial-endometrial junction in diagnosing other non-specific endometria, they were 81.25, 89.23, 78.79 and 90.62 %; for scattered vessel pattern in diagnosing endometrial hyperplasia, they were 88.89, 88.64, 44.4 and 98.73 % and for circular flow pattern in diagnosing submucosal fibroids, they were 80, 100, 100 and 97.75 %, respectively. The color score of the endometrium was not statistically different among different endometrial pathologies (P value >0.05). |
4 |
| 58. Timmerman D, Verguts J, Konstantinovic ML, et al. The pedicle artery sign based on sonography with color Doppler imaging can replace second-stage tests in women with abnormal vaginal bleeding. Ultrasound Obstet Gynecol. 2003; 22(2):166-171. |
Observational-Dx |
3,099 patients |
To determine accuracy of pedicle artery test in detecting endometrial polyps. |
Of the 3,099 women, no gold standard was available in 2,230. Only 28/199 patients who were test-positive did not have a gold standard. In the 869 patients in whom a gold standard was available, 182 had one or more endometrial polyps. The pedicle artery test had an apparent sensitivity for detection of endometrial polyps of 76.4%, specificity of 95.3%, PPV of 81.3%, and NPV of 93.8%. When extending the test to the prediction of any focal intracavitary pathology the PPV was 94.2%. |
3 |
| 59. Omary RA, Vasireddy S, Chrisman HB, et al. The effect of pelvic MR imaging on the diagnosis and treatment of women with presumed symptomatic uterine fibroids. J Vasc Interv Radiol 2002;13:1149-53. |
Observational-Dx |
60 patients |
To determine if magnetic resonance (MR) imaging significantly alters the diagnostic thinking and treatment plans of interventional radiologists during the evaluation of women for uterine fibroid embolization (UFE) for presumed uterine fibroids. |
MR imaging caused a mean gain in diagnostic confidence of 22% (P <.0001). MR imaging changed initial diagnoses in 11 patients (18%). Immediate clinical management changed in 13 patients (22%). UFE was not performed in 11 of 57 women (19%) who were anticipated before MR imaging to receive UFE. |
3 |
| 60. Spielmann AL, Keogh C, Forster BB, Martin ML, Machan LS. Comparison of MRI and sonography in the preliminary evaluation for fibroid embolization. AJR Am J Roentgenol 2006;187:1499-504. |
Observational-Dx |
49 patients |
To evaluate whether pelvic MRI provides additional clinically relevant information after sonography in the preprocedure evaluation of uterine artery embolization of fibroids. |
One hundred twenty-two fibroids were measured. The uterine volume was significantly smaller as measured on MRI compared with sonography (p = 0.01). We found good MRI and sonography correlation of the volume of the single largest fibroid in each patient (R = 0.87) but poor correlation of fibroid location (R = 0.17). MRI detected 31 paraendometrial fibroids and three pedunculated fibroids that were thought to be intramural fibroids on sonography. Five fibroids thought to be paraendometrial on sonography were confirmed to be subserosal or intramural on MRI. Discrepancy in the total number of fibroids was noted, with additional fibroids found on MRI in 31 of 49 patients and erroneously suspected on sonography in five of 49 patients. Pelvic MRI affected management in 11 of 49 patients, leading to cancellation of uterine artery embolization in four patients. In another seven patients who were originally thought to be poor candidates on the basis of sonographic findings, uterine artery embolization was performed. MRI did not alter the management plan in 38 patients. |
2 |
| 61. Franconeri A, Fang J, Carney B, et al. Structured vs narrative reporting of pelvic MRI for fibroids: clarity and impact on treatment planning. Eur Radiol. 28(7):3009-3017, 2018 Jul. |
Review/Other-Dx |
29 patients |
To evaluate clarity and usefulness of MRI reporting of uterine fibroids using a structured disease-specific template vs. narrative reporting for planning of fibroid treatment by gynaecologists and interventional radiologists. |
More key features were absent in the narrative reports 7.3 +/- 2.5 (range 3-12) than in structured reports 1.2 +/- 1.5 (range 1-7), (p < 0.0001). Compared to narrative reports, gynaecologists and radiologists deemed structured reports both more helpful for surgical planning (p < 0.0001) (gynaecologists: 8.5 +/- 1.2 vs. 5.7 +/- 2.2; radiologists: 9.6 +/- 0.6 vs. 6.0 +/- 2.9) and easier to understand (p < 0.0001) (gynaecologists: 8.9 +/- 1.1 vs. 5.8 +/- 1.9; radiologists: 9.4 +/- 1.3 vs. 6.3 +/- 1.8). |
4 |
| 62. Chung YJ, Kang SY, Chun HJ, et al. Development of a Model for the Prediction of Treatment Response of Uterine Leiomyomas after Uterine Artery Embolization. Int J Med Sci. 15(14):1771-1777, 2018. |
Observational-Dx |
198 patients |
To identify factors associated with the efficacy of UAE for the treatment of uterine leiomyoma, and to develop a model for the prediction of treatment response of uterine leiomyomas to UAE. |
After a logistic regression analysis, leiomyoma location and T2 signal intensity of the largest leiomyoma were found to be statistically significant variables. Using intramural myomas defined as controls, submucosal leiomyomas showed a greater response to UAE with an odds ratio of 7.6904. The odds ratio of T2 signal intensity with an increase in signal intensity of 10 was 1.093. Using these two variables, we developed a prediction model. The AUC in the prediction model was 0.833, and the AUC in the validation set was 0.791. |
3 |
| 63. Kalina I, Toth A, Valcseva E, et al. Prognostic value of pre-embolisation MRI features of uterine fibroids in uterine artery embolisation. Clin Radiol. 73(12):1060.e1-1060.e7, 2018 12. |
Observational-Dx |
70 patients |
To evaluate the prognostic value of pretreatment pelvic magnetic resonance imaging (MRI) features in uterine artery embolisation (UAE) for symptomatic fibroids. |
The mean fibroid volume decreased by 51.1+/-30.8% during the 6.6+/-1.8 months (p<0.001). Mean quality-of-life score improved by 48.2+/-27.6 points (p<0.001). The mean VR of submucosal fibroids (82.1+/-18.5%) was greater than that of intramural (49.4+/-30.7%) and subserosal (43+/-28.3%) fibroids (p<0.001 for both). Fibroids that were isointense/hyperintense to myometrium on T2-weighted images showed a better response than hypointense fibroids (63.7+/-25.8% versus 48.6+/-31.3%, respectively; p=0.041). On contrast-enhanced images, isointense/hyperintense fibroids showed a better VR than hypointense fibroids (61.3+/-27.4% versus 47.6+/-31.6%, respectively; p=0.035). Baseline fibroid volume of <50 cm(3) was also associated with favourable imaging outcome (p=0.021). T2 SI compared to skeletal muscle and T1 SI compared to myometrium or skeletal muscle did not show association with VR. |
3 |
| 64. Sipola P, Ruuskanen A, Yawu L, et al. Preinterventional quantitative magnetic resonance imaging predicts uterus and leiomyoma size reduction after uterine artery embolization. J Magn Reson Imaging. 31(3):617-24, 2010 Mar. |
Observational-Dx |
52 patients |
To investigate the relationship between magnetic resonance imaging (MRI) measures and uterus and leiomyoma size reductions after uterine artery embolization (UAE). |
Uterus and dominant leiomyoma size reductions were highly variable. Leiomyoma size reductions of >or=75% were accurately predicted with leiomyoma-to-skeletal muscle T2 SI-ratio (ROC curve A(z) = 0.930; 95% confidence interval [CI]: 0.853, 1.000). Leiomyoma size reductions >or=75% were predicted by leiomyoma-to-skeletal muscle T2 SI-ratio >or=3.5 and T1-time >or=750 msec with 100% and 86% sensitivities and 67% and 72% specificities, respectively. Uterus size reduction >or=50% were identified by dominant leiomyoma-to-skeletal muscle T2 SI-ratio >or=2.5. |
4 |
| 65. Tang Y, Chen C, Duan H, Ma B, Liu P. Low vascularity predicts favourable outcomes in leiomyoma patients treated with uterine artery embolization. Eur Radiol. 26(10):3571-9, 2016 Oct. |
Observational-Dx |
183 patients |
To investigate the clinical factors predicting outcomes of leiomyoma treated with uterine artery embolization (UAE). |
Twenty-three recurrences were recorded. The difference in the vascularity classification systems between MRI and DSA was not statistically significant (P = 0.059). High vascularity in MRI, high vascularity in DSA and multiple leiomyoma showed a significant risk of recurrence using univariate and multivariate analysis (P = 0.004, P < 0.001 and P = 0.023, respectively). The other factors were not significantly associated with leiomyoma recurrence (P > 0.05). |
3 |
| 66. Dutton S, Hirst A, McPherson K, Nicholson T, Maresh M. A UK multicentre retrospective cohort study comparing hysterectomy and uterine artery embolisation for the treatment of symptomatic uterine fibroids (HOPEFUL study): main results on medium-term safety and efficacy. BJOG 2007;114:1340-51. |
Observational-Tx |
451 patients |
To compare medium-term safety and efficacy of hysterectomy and uterine artery embolisation (UAE) for symptomatic uterine fibroids. |
Fewer complications were experienced by women receiving UAE (19 versus 26% hysterectomy, P = 0.001), the adjusted odds ratio for UAE versus hysterectomy was 0.48 (95% CI 0.26-0.89). One-third of women undergoing UAE experienced anticipated general side effects associated with the procedure. More women in the hysterectomy cohort reported relief from fibroid symptoms (95 versus 85%, P < 0.0001) and feeling better (96 versus 84%, P < 0.0001), but only 85% would recommend the treatment to a friend compared with 91% in the UAE arm (P = 0.007). There was a 23% (95% CI 19-27%) chance of requiring further treatment for fibroids after UAE. Twenty-seven women who had had UAE reported 37 pregnancies after treatment resulting in 19 live births. |
2 |
| 67. Keung JJ, Spies JB, Caridi TM. Uterine artery embolization: A review of current concepts. [Review]. Best Pract Res Clin Obstet Gynaecol. 46:66-73, 2018 Jan. |
Review/Other-Dx |
N/A |
To provide an overview of current concepts with regard to patient selection, technique, and outcomes following UAE. |
No results stated in abstract. |
4 |
| 68. Campbell J, Rajan DK, Kachura JR, et al. Efficacy of Ovarian Artery Embolization for Uterine Fibroids: Clinical and Magnetic Resonance Imaging Evaluations. Can Assoc Radiol J. 66(2):164-70, 2015 May. |
Observational-Dx |
17 patients |
To assess the efficacy of ovarian artery embolization (OAE) treatment for symptomatic uterine leiomyomas. |
Mean MR imaging follow-up was performed 3 months post-OAE. MR images showed complete infarction in the majority of cases (64.7%; n = 11), with infarction rates of 90%-100% in 3 cases, 1 case with 30%-50% infarction, and 2 cases with 0%-10% infarction. Average uterine size reduction on MR was 32.3% (95% confidence interval [CI]: 22.5%-42.2%; P < .001). The average size reduction for the dominant fibroid was 42.4% (95% CI: 27.7%-57.0%; P = .01). The mean time to final follow-up visit was 11 months. At this point complete symptom resolution (menorrhagia, dysmenorrhea and bulk-related) was achieved in 82.4% (n = 14) of cases. At the final follow-up 11.8% (n = 2) of cases reported menopause. |
3 |
| 69. Gupta A, Grunhagen T. Live MR angiographic roadmapping for uterine artery embolization: a feasibility study. J Vasc Interv Radiol. 24(11):1690-7, 2013 Nov. |
Observational-Dx |
20 Patients |
To assess the feasibility of live magnetic resonance (MR) angiography roadmapping guidance for uterine artery (UA) embolization (UAE) for fibroid tumors. |
In all 20 patients (40 UAs), the MR angiography overlay on live fluoroscopy was accurate and allowed for successful catheterization of the UA, resulting in a technical success rate of 100%. In the subset of the initial 20 UAs (ie, the first 10 patients) in which this data point was recorded, 17 (85%) were successfully catheterized with no iodinated contrast medium at all, by purely relying on the MR angiography roadmap. Mean procedure time was 45 minutes (range, 30–99 min), mean contrast agent dose was 75 mL (range, 46–199 mL), and mean DAP was 155 Gy·cm2 (range, 37–501 Gy·cm2). |
4 |
| 70. Koesters C, Powerski MJ, Froeling V, Kroencke TJ, Scheurig-Muenkler C. Uterine artery embolization in single symptomatic leiomyoma: do anatomical imaging criteria predict clinical presentation and long-term outcome?. Acta Radiol. 55(4):441-9, 2014 May. |
Observational-Dx |
91 patients |
To evaluate whether anatomical characteristics in women with a single symptomatic leiomyoma influence clinical presentation and outcome after UAE. |
Follow-up was available in 79/91 (87%) women (median age, 42 years; range, 33-56 years) at a median of 5 years (range, 3.1-9.2 years) after UAE. Anatomical leiomyoma criteria neither connected to specific clinical presentation nor influenced clinical outcome. Younger women showed a higher risk for TF with every year older lowering the risk by the factor of 0.86 (P = 0.024). Subgroup analysis showed predictive value of fibroid infarction with a cumulative survival free from TF of 91% for complete vs. 0% for partial infarction (P < 0.001). |
3 |
| 71. Nikolaidis P, Siddiqi AJ, Carr JC, et al. Incidence of nonviable leiomyomas on contrast material-enhanced pelvic MR imaging in patients referred for uterine artery embolization. J Vasc Interv Radiol 2005;16:1465-71. |
Observational-Dx |
100 patients |
To assess the incidence of nonviable leiomyomas in patients referred for uterine artery embolization (UAE) with use of contrast material-enhanced pelvic magnetic resonance (MR) imaging and to determine the effect of this information on interventional radiologists' decision to perform UAE or consider other treatment options. |
In 94 patients, 381 leiomyomas exceeding 3 cm in each dimension were recorded. Twenty-one patients (22%) did not receive embolization based on the findings of preprocedural MR imaging. In six patients (6%), there were nine nonviable dominant tumors with an average size of 7.8 cm3. These cases were not treated with UAE. Another 15 patients (16%) did not undergo UAE based on other MR imaging findings (including uterine size, presence of isolated adenomyosis, and endometrial lesions). |
4 |
| 72. Dao D, Kang SJ, Midia M. The utility of apparent diffusion coefficients for predicting treatment response to uterine arterial embolization for uterine leiomyomas: a systematic review and meta-analysis. Diagn Interv Radiol. 25(2):157-165, 2019 Mar. |
Meta-analysis |
12 studies |
To examine the value of baseline ADC values for predicting leiomyoma size reduction after uterine arterial embolization (UAE). |
The weighted mean+/-SD ADC value was 1.2+/-1.5 x10-3 s/mm2 at baseline (ten studies) and 1.3+/-2.8 x10-3 s/mm2 at approximately 6 months after embolization (six studies). The weighted mean percentage leiomyoma volume reduction (VR) at 6 months was 47.1%+/-35.6% (seven studies). Based on four studies, the weighted summary correlation coefficient for the correlation between baseline ADC and leiomyoma VR at approximately 6 months was not significant (r=0.40; 95% CI, -0.07 to 0.72; I2=69.7%). No associations were found in three of the four studies that examined changes in ADC values as a predictor. |
Good |
| 73. Keserci B, Duc NM. Magnetic Resonance Imaging Parameters in Predicting the Treatment Outcome of High-intensity Focused Ultrasound Ablation of Uterine Fibroids With an Immediate Nonperfused Volume Ratio of at Least 90. Acad Radiol. 25(10):1257-1269, 2018 10. |
Observational-Dx |
120 patients |
To investigate the role of magnetic resonance imaging parameters in predicting the treatment outcome of high-intensity focused ultrasound (HIFU) ablation of uterine fibroids with a nonperfused volume (NPV) ratio of at least 90%. |
By introducing multiple predictors obtained from multivariate analyses into a generalized estimating equation model, the results showed that the thickness of the subcutaneous fat layer in the anterior abdominal wall, peak enhancement of fibroid, time to peak of fibroid, and the ratio of area under the curve of fibroid to myometrium were statistically significant, except T2 signal intensity ratio of fibroid to myometrium, hence predicting an NPV ratio of at least 90%. No serious adverse effects and no significant difference between the anti-Mullerian hormone levels before or 6 months post-treatment were reported. |
3 |
| 74. Kim YS, Lim HK, Park MJ, et al. Screening Magnetic Resonance Imaging-Based Prediction Model for Assessing Immediate Therapeutic Response to Magnetic Resonance Imaging-Guided High-Intensity Focused Ultrasound Ablation of Uterine Fibroids. Invest Radiol. 51(1):15-24, 2016 Jan. |
Observational-Dx |
152 patients |
To fit and validate screening magnetic resonance imaging (MRI)-based prediction models for assessing immediate therapeutic responses of uterine fibroids to MRI-guided high-intensity focused ultrasound (MR-HIFU) ablation. |
Generalized estimating equation analyses yielded models of y1 = 2.2637 - 0.0415x1 - 0.0011x2 - 0.0772x3 and y2 = 6.8148 - 0.1070x1 - 0.0050x2 - 0.2163x3. Cutoff values were 1.312 for ablation efficiency (area under the curve, 0.7236; sensitivity, 0.6882; specificity, 0.6866) and 4.019 for ablation quality (0.8794; 0.7156; 0.9020). Positive and negative predictive values were 0.917 and 0.500 for ablation efficiency and 0.978 and 0.600 for ablation quality, respectively. |
3 |
| 75. Mindjuk I, Trumm CG, Herzog P, Stahl R, Matzko M. MRI predictors of clinical success in MR-guided focused ultrasound (MRgFUS) treatments of uterine fibroids: results from a single centre. Eur Radiol. 25(5):1317-28, 2015 May. |
Observational-Dx |
252 patients |
To assess the technical and clinical results of MRgFUS treatment and factors affecting clinical treatment success. |
NPV ratio was significantly higher in fibroids characterized by low signal intensity in contrast-enhanced T1-weighted fat saturated MR images and in fibroids distant from the spine (>3 cm). NPV ratio was lower in fibroids with septations, with subserosal component and in skin-distant fibroids (p < 0.001). NPV ratio was highly correlated with clinical success: NPV of more than 80 % resulted in clinical success in more than 80 % of patients. Reintervention rate was 12.7 % (mean follow-up time, 19.4 +/- 8 months; range, 3-38). Expulsion of fibroids (21 %) was significantly correlated with a high clinical success rate. No severe adverse events were reported. |
3 |
| 76. Yeo SY, Kim YS, Lim HK, Rhim H, Jung SH, Hwang NY. Uterine fibroids: Influence of "T2-Rim sign" on immediate therapeutic responses to magnetic resonance imaging-guided high-intensity focused ultrasound ablation. Eur J Radiol. 97:21-30, 2017 Dec. |
Observational-Dx |
123 patients |
To investigate the influence of a high-signal-intensity peripheral rim on T2-weighted MR images (i.e., T2-rim sign) on the immediate therapeutic responses of MR-guided high intensity focused ultrasound (MR-HIFU) ablation of uterine fibroids. |
The presence of a T2-rim sign significantly lowered the NPV ratio (54.0+/-28.0% vs. 83.7+/-17.7%), ablation efficiency (0.6+/-0.5 vs. 1.3+/-0.6), ablation quality (3.1+/-1.2 vs. 4.2+/-0.8), (P<0.0001). GEE analysis showed that the presence of a T2-rim sign was independently significant for ablation efficiency and ablation quality (P<0.05). |
3 |
| 77. Ghai S, Rajan DK, Benjamin MS, Asch MR, Ghai S, Uterine artery embolization for leiomyomas: pre- and postprocedural evaluation with US. [Review] [60 refs]. Radiographics. 25(5):1159-72; discussion 1173-6, 2005 Sep-Oct. |
Review/Other-Dx |
N/A |
To evaluate the role of ultrasound for uterine artery embolization of leiomyomas. |
No results stated in abstract. |
4 |
| 78. Weintraub JL, Romano WJ, Kirsch MJ, Sampaleanu DM, Madrazo BL. Uterine artery embolization: sonographic imaging findings. J Ultrasound Med 2002;21:633-7; quiz 39-40. |
Observational-Dx |
14 patients |
To examine the sonographic and angiographic imaging findings before and after uterine fibroid embolization for symptomatic leiomyoma. |
Preprocedure sonographic imaging showed a varied appearance to the fibroids. Color Doppler imaging primarily showed the fibroids to be vascular with marked peripheral blood flow. Postprocedure sonographic imaging showed decreased uterine size and echogenicity. Color Doppler imaging showed a marked decrease in the blood flow to the leiomyoma. There was no statistical significance in the relationship between echogenicity and vascularity shown before the procedure and the percent decrease in the size of the uterus. |
4 |
| 79. Czuczwar P, Wozniak S, Szkodziak P, et al. Influence of ulipristal acetate therapy compared with uterine artery embolization on fibroid volume and vascularity indices assessed by three-dimensional ultrasound: prospective observational study. Ultrasound Obstet Gynecol. 45(6):744-50, 2015 Jun. |
Observational-Tx |
17 patients |
To compare the effects of two alternative treatment options for uterine fibroids, ulipristal acetate (UPA) and uterine artery embolization (UAE), on fibroid volume and vascularity at 3-month follow-up. |
In both the UPA and UAE groups, fibroid volumes decreased significantly after treatment in comparison with baseline volumes obtained prior to treatment. The percentage of fibroid volume reduction after 3 months of UPA therapy (48.1%) was not significantly different from the reduction seen 3 months after the UAE procedure (47.3%). All vascular indices decreased significantly after treatment by UPA or UAE. The percentage reduction in VI and VFI 3 months after UAE (95.4% for both) was significantly greater than the percentage reduction in patients after 3 months of UPA therapy (51.5% and 62.5%, respectively); however the difference in FI reduction between treatment groups did not reach significance (54.3% for UAE and 30.9% for UPA). No significant side-effects were observed in either treatment group. |
3 |
| 80. Tal R, Segars JH. The role of angiogenic factors in fibroid pathogenesis: potential implications for future therapy. Hum Reprod Update 2014;20:194-216. |
Observational-Dx |
N/A |
To review the role of angiogenic factors in fibroid pathogenesis for potential implications for future therapy. |
No results stated in abstract. |
4 |
| 81. McLucas B, Perrella R, Goodwin S, Adler L, Dalrymple J. Role of uterine artery Doppler flow in fibroid embolization. J Ultrasound Med 2002;21:113-20; quiz 22-3. |
Observational-Dx |
227 patients |
To determine whether Doppler flow measurements are useful in predicting variables associated with uterine fibroid embolization, including shrinkage of the uterus and myomas, adenomyosis, and uterine fibroid embolization failure. |
Initial peak systolic velocity was positively correlated with the size and shrinkage of myomas and uterine volume. Peak systolic velocity was positively correlated with the size and load of embolization particles and was significantly lower (mean, 33.2 cm/s) in patients with adenomyosis than those without adenomyosis (mean, 39.3 cm/s). High peak systolic velocity (>64 cm/s) was a significant predictor of failure. Postembolization peak systolic velocity (mean, 21.85 cm/s) was significantly lower than preembolization peak systolic velocity (mean, 40.33 cm/s) and was not correlated with uterine fibroid embolization variables. |
3 |
| 82. Nieuwenhuis LL, Keizer AL, Stoelinga B, et al. Fibroid vascularisation assessed with three-dimensional power Doppler ultrasound is a predictor for uterine fibroid growth: a prospective cohort study. BJOG. 125(5):577-584, 2018 Apr. |
Observational-Dx |
66 patients |
To analyse fibroid vascularisation measured with three-dimensional (3D) power Doppler in relation to absolute fibroid volume change during 12 months of follow up and in relation to fibroid growth rate per year. |
In all, 66 women (mean age 42 years) completed 12 months of follow up without treatment. Baseline fibroid vascularisation (VI) measured with 3D power Doppler is correlated with fibroid volume at 12 months (P = 0.02 ). An increase of 1% in VI at baseline was associated with a 7.00-cm(3) larger fibroid volume at 12 months. Furthermore, vascularisation was also associated with fibroid growth rate per year (P = 0.04). |
3 |
| 83. Verma SK, Gonsalves CF, Baltarowich OH, Mitchell DG, Lev-Toaff AS, Bergin D. Spectrum of imaging findings on MRI and CT after uterine artery embolization. Abdom Imaging. 35(1):118-28, 2010 Feb. |
Review/Other-Dx |
N/A |
To identify the spectrum of findings on MRI and CT performed after UAE, to illustrate UAE-associated common and uncommon MRI and CT appearances and discuss post-UAE complications that require urgent medical or surgical intervention. |
No results stated in abstract. |
4 |
| 84. Deshmukh SP, Gonsalves CF, Guglielmo FF, Mitchell DG. Role of MR imaging of uterine leiomyomas before and after embolization. [Review]. Radiographics. 32(6):E251-81, 2012 Oct. |
Review/Other-Dx |
N/A |
To review the role of MRI for the detection and evaluation of leiomyomas. |
MRI is the most accurate imaging technique for detection and evaluation of leiomyomas and therefore has become the imaging modality of choice before and after uterine fibroid embolization. As leiomyomas enlarge, they may outgrow their blood supply, resulting in various forms of degeneration that change their appearance. Leiomyomas are classified as submucosal, intramural, or subserosal. Submucosal and subserosal leiomyomas may be pedunculated, thus simulating other conditions. Understanding the MRI appearance of leiomyomas allows differentiation from other entities. The superior tissue contrast of MRI allows diagnosis of leiomyomas with a high level of confidence, ultimately leading to a decrease in the number of surgeries performed and thus reducing healthcare expenditures. MRI findings that influence the planning of uterine fibroid embolization include the location, size, number, and vascular supply of leiomyomas. In addition, MRI can be used to assess the success of uterine fibroid embolization and evaluate for potential complications. |
4 |
| 85. Kim YS, Lim HK, Kim JH, et al. Dynamic contrast-enhanced magnetic resonance imaging predicts immediate therapeutic response of magnetic resonance-guided high-intensity focused ultrasound ablation of symptomatic uterine fibroids. Invest Radiol. 46(10):639-47, 2011 Oct. |
Observational-Dx |
10 patients |
To evaluate dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters in the prediction of the immediate therapeutic response of MR-guided high-intensity focused ultrasound (HIFU) therapy in the treatment of symptomatic uterine fibroids |
We used 293 treatment cells (4 mm, n = 12; 8 mm, n = 115; 12 mm, n = 149; 16 mm, n = 17), and all of them were analyzable. Ablation efficacies were 1.06 +/- 0.58 and 0.67 +/- 0.39. K (B = -12.035, P < 0.001 and B = -11.516, P < 0.001, respectively) among DCE-MRI parameters and acoustic power (B = 0.008, P < 0.001; B = 0.010, P < 0.001, respectively) among therapy parameters were revealed to be independently significant predictors for both types of ablation efficacy. |
3 |
| 86. Naguib NN, Mbalisike E, Nour-Eldin NE, et al. Leiomyoma volume changes at follow-up after uterine artery embolization: correlation with the initial leiomyoma volume and location. J Vasc Interv Radiol. 21(4):490-5, 2010 Apr. |
Observational-Dx |
28 patients |
To study the changes in uterine leiomyoma volume after uterine artery embolization (UAE) and to correlate these changes with the initial tumor volume and location within the uterus. |
The mean pre-UAE volume of the leiomyomas was 51.6 cm(3) (range, 0.72-371.1 cm(3); SD, 79.3). Seven tumors were submucous, 28 intramural, and 49 subserous. At 3-month follow-up, 83 tumors (98.8%) showed volume reduction (mean, 52.62% +/- 21.85%; range, 12.79%-96.67%) and one (1.2%) increased in volume. At 1-year follow-up, five tumors (6%) were undetectable, 72 (85.7%) showed a further volume reduction of 20.5% +/- 11.92% (range, 2.52%-58.72%) relative to the 3-month volume, and seven (8.3%) increased in volume. A statistically significant difference (P = .026 at 3 months and P = .0046 at 1 year) in percentage of volume change was observed based on tumor location; submucous tumors showed the greatest volume reduction and subserous tumors the least reduction. The initial tumor volume showed a weak negative correlation (Spearman correlation coefficients, -0.35 at 3 months and -0.36 at 1 year) with tumor volume change. |
4 |
| 87. Wei C, Fang X, Wang CB, Chen Y, Xu X, Dong JN. The predictive value of quantitative DCE metrics for immediate therapeutic response of high-intensity focused ultrasound ablation (HIFU) of symptomatic uterine fibroids. Abdom Radiol. 43(8):2169-2175, 2018 08. |
Observational-Dx |
65 patients |
To investigate the value of quantitative DCE-MRI parameters for predicting the immediate non-perfused volume ratio (NPVR) of HIFU therapy in the treatment of symptomatic uterine fibroids. |
(1) It was observed that the pretreatment K (trans), K ep, V e, and BF values of the NPVR >== 70% group were significantly lower compared to the NPVR < 70% group (p < 0.05). (2) The immediate NPVR was negatively correlated with the K (trans), BF, and BV values before HIFU treatment (r = - 0.561, - 0.712, and - 0.528, respectively, p < 0.05 for all). (3) The AUCs of pretreatment K (trans), BF, BV values, and K (trans) combined with BF used to predict the immediate NPVR were 0.810, 0.909, 0.795, and 0.922, respectively (p < 0.05 for all). (4) The mean time to calculate the variable parameters in each case was 7.5 min. |
3 |
| 88. Kroencke TJ, Scheurig C, Poellinger A, Gronewold M, Hamm B. Uterine artery embolization for leiomyomas: percentage of infarction predicts clinical outcome. Radiology. 255(3):834-41, 2010 Jun. |
Observational-Dx |
115 patients |
To determine the effect of partial versus complete leiomyoma infarction on relief of leiomyoma-related symptoms and freedom from invasive reinterventions and to assess if patient age, location of the dominant leiomyoma, number of leiomyomas, or baseline uterine and dominant leiomyoma volume were associated with clinical failure. |
One hundred thirteen patients completed at least one clinical follow-up. Twenty-four months after UAE, 50% +/- 15.2 (standard error) of the patients with partial infarction and 80% +/- 13.4 (standard error) of patients with almost complete infarction had undergone no reintervention. No patient with complete infarction needed a second treatment (P < .001). The hazard ratios for reintervention between the complete infarction group and the almost complete and partial infarction groups were 15.88 (95% confidence interval [CI]: 1.22, 2225.54; P = .034) and 73.08 (95% CI: 8.33, 9636.35; P < .001), respectively. There were significant differences in hazard ratios between patients with partial and those with complete infarction for persistence or recurrence of menorrhagia (hazard ratio, 7.45; 95% CI: 2.08, 28.31; P = .002) and bulk-related symptoms (hazard ratio, 5.90; 95% CI: 1.66, 21.92; P = .007). There was no significant correlation between patient age, number of leiomyomas, location of the dominant leiomyoma, or baseline uterine and dominant leiomyoma volume and clinical failure. |
3 |
| 89. Liao D, Xiao Z, Lv F, Chen J, Qiu L. Non-contrast enhanced MRI for assessment of uterine fibroids' early response to ultrasound-guided high-intensity focused ultrasound thermal ablation. Eur J Radiol. 122:108670, 2020 Jan. |
Observational-Dx |
508 patients |
To examine non-contrast enhanced MRI value to evaluate necrotic area and ablation rate of uterine fibroids after high-intensity focused ultrasound (HIFU) thermal ablation. |
Average ADC and DWI signal values before HIFU treatment were higher than those post-operation; the difference was statistically significant before and after ablation (P<0.05). After HIFU, 78.09 % (467 / 598) of DWI showed complete regular or irregular high-signal rings and 21.91 % (131 / 598) showed incomplete high-signal rings. No significant difference was noted between the complete high-signal ring volume on DWI and the non-enhanced volume (P>0.05); however, this difference was statistically significant compared with the incomplete high-signal ring volume on DWI (P<0.05). Two doctors had good agreements on evaluating the morphology of high-signal rings (kappa>0.75, P<0.05). |
3 |
| 90. Cao M, Qian L, Zhang X, et al. Monitoring Leiomyoma Response to Uterine Artery Embolization Using Diffusion and Perfusion Indices from Diffusion-Weighted Imaging. Biomed Res Int. 2017:3805073, 2017. |
Observational-Dx |
12 patients |
To investigate the potential of diffusion and perfusion indices (ADC and perfusion fraction f) from DWI at 3.0 T in monitoring treatment response to uterine artery embolization (UAE) at 6-month follow-up. |
Seventeen fibroids were studied. The median ADCs showed a significant increase from 1.20 x 10(-3) mm(2)/s (range, 0.86-1.66 x 10(-3) mm(2)/s) at baseline to 1.56 x 10(-3) mm(2)/s (range, 1.00-1.86 x 10(-3) mm(2)/s) at 6-month follow-up (P = 0.0003). Conversely, the median perfusion fraction f was significantly decreased after UAE (P = 0.0001), with a median pre-UAE value of 14.2% (range, 6.7%-17.6%) and a median post-UAE value of 9.2% (range, 3.2%-14.6%). Significant correlations were found between fibroid volume reduction rate and percentage changes in ADC and perfusion fraction f at 6-month follow-up relative to baseline, with rho values of -0.50 (P = 0.04) and 0.55 (P = 0.02), respectively. |
4 |
| 91. Sutter O, Soyer P, Shotar E, et al. Diffusion-weighted MR imaging of uterine leiomyomas following uterine artery embolization. Eur Radiol. 26(10):3558-70, 2016 Oct. |
Observational-Dx |
49 patients |
To test whether variations in apparent diffusion coefficient (ADC) values of uterine leiomyomas after uterine artery embolization (UAE) may correlate with outcome and assess the effects of UAE on leiomyomas and normal myometrium with magnetic resonance imaging (MRI). |
By comparison with baseline ADC values, a significant drop in leiomyoma ADC was found at 6-month post-UAE (1.096 x 10(-3) mm(2)/s vs. 0.712 x 10(-3) mm(2)/s, respectively; p < 0.0001), but not at 48-h post-UAE. Leiomyoma devascularization was complete in 40/49 women (82 %) at 48 h and in 37/49 women (76 %) at 6 months. Volume reduction and leiomyoma ADC values at 6 months correlated with the degree of devascularization. There was a significant drop in myometrium ADC after UAE. Perfusion defect of the myometrium was observed at 48 h in 14/49 women (28.5 %) in association with higher degrees of leiomyoma devascularization. |
4 |
| 92. Kirpalani A, Chong J, Yang N, et al. Diffusion-weighted imaging properties of uterine fibroids pre- and post-uterine fibroid embolisation. Eur J Radiol. 83(9):1620-5, 2014 Sep. |
Observational-Dx |
50 patients |
To determine the change in apparent diffusion coefficient (ADC) of uterine fibroids following uterine fibroid embolisation (UFE), and if the ADC change correlates with either volume loss or degree of contrast enhancement post-UFE. |
The mean ADC of all (n=88) fibroids pre-UFE was 1.30+/-0.20x10(-3)mm(2)/s, and increased to 1.68+/-0.24x10(-3)mm(2)/s post-UFE (p<0.0001). Lower pre-UFE ADC correlated with greater ADC change post-UFE (r=-0.50; p<0.0001). There was no correlation between ADC change and volume change post-UFE (r=0.07; p=0.59). However, fibroids with no residual enhancement post-UFE had larger ADC change than those with residual enhancement (p=0.003). |
4 |
| 93. Ikink ME, Voogt MJ, van den Bosch MA, et al. Diffusion-weighted magnetic resonance imaging using different b-value combinations for the evaluation of treatment results after volumetric MR-guided high-intensity focused ultrasound ablation of uterine fibroids. Eur Radiol. 24(9):2118-27, 2014 Sep. |
Observational-Dx |
56 patients |
To assess the value of diffusion-weighted magnetic resonance imaging (DWI) and apparent diffusion coefficient (ADC) mapping using different b-value combinations for treatment evaluation after magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) of uterine fibroids. |
Using the lowest b-values (0 and 200 s/mm(2)), the mean ADC value in the ablated tissue reduced significantly (p < 0.001) compared with baseline. Calculating the ADC value with the highest b-values (400, 600, 800 s/mm(2)), the ADC increased significantly (p < 0.001) post-treatment. ADC maps calculated with the lowest b-values resulted in the best visual agreement of non-perfused fibroid tissue detected on CE images. Other b-value combinations and normal myometrium showed no difference in ADC after MR-HIFU treatment. |
3 |
| 94. Jacobs MA, Gultekin DH, Kim HS. Comparison between diffusion-weighted imaging, T2-weighted, and postcontrast T1-weighted imaging after MR-guided, high intensity, focused ultrasound treatment of uterine leiomyomata: preliminary results. Med Phys. 37(9):4768-76, 2010 Sep. |
Observational-Dx |
21 patients |
To investigate the comparison between diffusion-weighted imaging (DWI), T2-weighted imaging, (T2WI) and contrast T1-weighted imaging (cT1WI) in uterine leiomyoma following treatment by magnetic resonance imaging-guided, high intensity focused ultrasound surgery (MRg-HIFUS). |
All the patients exhibited heterogeneously increased DWI signal intensity localized in the treated fibroid regions and were colocalized with the cT1WI defined area. The mean pretreatment T2WI signal intensity ratios were T2WI/muscle = 1.8 +/- 0.7 and T2WI/myometrium = 0.7 +/- 0.4. The congruence between the regions was significant, with a similarity of 84% and a difference of 8% between the regions. Regression analyses of the cT1WI and DWI segmented treatment volume were found to be significantly correlated (r2 = 0.94, p < 0.05) with the linear equation, (cT1WI) = 1.1 (DWI)-0.66. There is good agreement between the regions defined by cT1WI and DWI in most of the cases as shown from the Bland-Altman plots. |
3 |
| 95. Li C, Jin C, Liang T, et al. Magnetic resonance-guided high-intensity focused ultrasound of uterine fibroids: whole-tumor quantitative perfusion for prediction of immediate ablation response. Acta Radiol. 61(8):1125-1133, 2020 Aug. |
Observational-Dx |
28 patients |
To investigate the value of whole-tumor ROI (ROIwt) analysis for quantitative perfusion in predicting immediate ablation response of uterine fibroids in MR-HIFU. |
The intra- and inter-observer ICC of the quantitative perfusion parameters from ROIwt were higher than those from ROIsl. Multivariate analysis showed that the K(trans) of ROIwt was a predictor of the immediate ablation response. ROC analysis displayed that the AUC of K(trans) of ROIwt is 0.817 in predicting the ablation response. |
4 |
| 96. Munro MG, Storz K, Abbott JA, et al. AAGL Practice Report: Practice Guidelines for the Management of Hysteroscopic Distending Media: (Replaces Hysteroscopic Fluid Monitoring Guidelines. J Am Assoc Gynecol Laparosc. 2000;7:167-168.). J Minim Invasive Gynecol 2013;20:137-48. |
Review/Other-Dx |
N/A |
To provide clinicians with evidence-based information about commonly used and available hysteroscopic distending media to guide them in their performance of both diagnostic and operative hysteroscopy. |
No results stated in abstract. |
4 |
| 97. Walker WJ, Pelage JP. Uterine artery embolisation for symptomatic fibroids: clinical results in 400 women with imaging follow up. BJOG 2002;109:1262-72. |
Observational-Tx |
403 Patients |
To evaluate the mid-term efficacy and complications of uterine artery embolisation in women with symptomatic fibroids and to assess reduction in uterine and dominant fibroid volumes using ultrasound and magnetic resonance imaging. |
Bilateral uterine artery embolisation was achieved in 395 women, while 5 women had a unilateral procedure. With a mean clinical follow up of 16.7 months, menstrual bleeding was improved in 84% of women and menstrual pain was improved in 79%. Using ultrasound, the median uterine and dominant fibroid volumes before embolisation were 608 and 112 cc, respectively, and after embolisation 255 and 19 cc, respectively (P = .0001). Three (1%) infective complications requiring emergency hysterectomy occurred. Twenty-three (6%) patients had clinical failure or recurrence. Of these, nine (2%) had a hysterectomy. Twenty-six (7%) women had permanent amenorrhoea after embolisation including four patients under the age of 45 (2%). Of these, amenorrhea started between 4 and 18 months after embolisation, and only three had elevated follicle stimulating hormone levels when amenorrhea developed. Thirteen (4%) women had chronic vaginal discharge considered as a major irritant. Thirteen pregnancies occurred in 12 patients. Ninety-seven percent of women were pleased with the outcome and would recommend this treatment to others. |
2 |
| 98. Vott S, Bonilla SM, Goodwin SC, et al. CT findings after uterine artery embolization. J Comput Assist Tomogr 2000;24:846-8. |
Review/Other-Dx |
N/A |
To review CT findings after uterine artery embolization. |
No results stated in abstract. |
4 |
| 99. Nicholson TA, Pelage JP, Ettles DF. Fibroid calcification after uterine artery embolization: ultrasonographic appearance and pathology. J Vasc Interv Radiol 2001;12:443-6. |
Observational-Dx |
38 patients |
To describe the ultrasonographic (US) appearance of fibroid calcification occurring after uterine artery embolization (UAE) and discuss its etiology and pathology. |
Twenty patients reported complete resolution of symptoms. In 16 of these, a reduction in fibroid volume of 70%-85% was recorded and, at US, the development of a peripheral hyperechoic rim around an increasingly hypoechoic fibroid was noted. Computed tomography in two patients revealed it to be a rim of calcium. Histologic studies in a different cohort of patients who had undergone hysterectomy at variable intervals after UAE demonstrated early aggregation of polyvinyl alcohol (PVA) particles, an intermediate giant cell inflammatory reaction, and calcification in the periphery of the infarcted fibroid at 6-12 months. |
4 |
| 100. Tranquart F, Brunereau L, Cottier JP, et al. Prospective sonographic assessment of uterine artery embolization for the treatment of fibroids. Ultrasound Obstet Gynecol 2002;19:81-7. |
Observational-Dx |
58 patients |
To evaluate sonographic features following uterine artery embolization and to assess using ultrasound the efficacy of embolization as the primary treatment of fibroids. |
Fifty-eight patients were examined at 3 months, 46 at 6 months, 36 at 1 year and 19 at 2 years. Most patients were improved or free of symptoms at 3 months (90%), 6 months (92%) and 1 year (87%) and all monitored patients were free of symptoms at 2 years. Clinical failure of treatment occurred in only two cases (3%). Progressive significant reduction in fibroid size with reference to the baseline was demonstrated during follow-up from 3 months (-29%) to 24 months (-86%). Absence of intrafibroid vessels was observed in all except three cases as early as 3 months, whereas perifibroid vessels persisted in 21 cases. No changes in uterine vascularization or uterine artery resistance were noted. |
4 |
| 101. American College of Radiology. ACR Appropriateness Criteria® Radiation Dose Assessment Introduction. Available at: https://www.acr.org/-/media/ACR/Files/Appropriateness-Criteria/RadiationDoseAssessmentIntro.pdf. |
Review/Other-Dx |
N/A |
To provide evidence-based guidelines on exposure of patients to ionizing radiation. |
No abstract available. |
4 |
