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Can measurement of apparent diffusion coefficient before treatment predict the response to uterine artery embolization for adenomyosis?

 Yaewon Park  ;  Man Deuk Kim  ;  Dae Chul Jung  ;  Shin Jae Lee  ;  Gyoungmin Kim  ;  Sung Il Park  ;  Jong Yun Won  ;  Do Yun Lee 
 EUROPEAN RADIOLOGY, Vol.25(5) : 1303-1309, 2015 
Journal Title
Issue Date
Adenomyosis/therapy* ; Adult ; Contrast Media ; Diffusion Magnetic Resonance Imaging/methods* ; Female ; Humans ; Image Enhancement ; Meglumine ; Myometrium/pathology ; Organometallic Compounds ; Polyvinyl Alcohol/therapeutic use ; Prospective Studies ; Sensitivity and Specificity ; Treatment Outcome ; Uterine Artery Embolization/methods*
Uterine arterial embolization ; Adenomyosis ; Magnetic resonance ; Apparent diffusion coefficient ; Prediction of improvement
OBJECTIVES: To determine the usefulness of the apparent diffusion coefficient (ADC) in predicting response to uterine artery embolization (UAE) for symptomatic adenomyosis. METHODS: A prospective study was performed on 25 patients who underwent diffusion-weighted (DW) magnetic resonance imaging (MRI) before UAE between June 2011 and December 2012. All patients underwent 3-month follow-up MRI after UAE using non-spherical polyvinyl alcohol (PVA) particles ranging from 150 to 500 μm. Quantitative measurement of the ADC was performed for each adenomyosis. Complete response and incomplete response were defined as ≥ 90 % or < 90 %, respectively, of the non-perfusion area with adenomyosis at the follow-up MRI. The ADC values were compared between patients who achieved complete or incomplete response which was assessed according to the MRI findings after UAE. RESULTS: Nineteen patients showed complete response, and six showed incomplete response. The ADC value ranged from 0.842 to 1.346 × 10(-3) mm(2)/s (mean 1.075 ± 0.117). The mean ADC was 1.043 ± 0.237 in the complete response group and 1.176 ± 0.429 in the incomplete response group (0.012). Using a threshold of <1.147 × 10(-3) mm(2)/s, the sensitivity and specificity of the ADC to predict success after UAE were 83.3 % and 84.2 %. CONCLUSION: The ADC of adenomyosis may potentially predict a successful response to UAE for adenomyosis. KEY POINTS: • Pre-procedural MRI might help clinicians predict response of UAE in adenomyosis • ADC might help predict UAE outcomes in adenomyosis • MR predictors might be used to counsel patients with symptomatic adenomyosis.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Gyoung Min(김경민) ORCID logo https://orcid.org/0000-0001-6768-4396
Kim, Man Deuk(김만득) ORCID logo https://orcid.org/0000-0002-3575-5847
Park, Sung Il(박성일)
Park, Yae Won(박예원) ORCID logo https://orcid.org/0000-0001-8907-5401
Won, Jong Yun(원종윤) ORCID logo https://orcid.org/0000-0002-8237-5628
Lee, Do Yun(이도연)
Lee, Shin Jae(이신재)
Jung, Dae Chul(정대철) ORCID logo https://orcid.org/0000-0001-5769-5083
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