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Apparent Diffusion Coefficient of Uterine Leiomyoma as a Predictor of the Potential Response to Uterine Artery Embolization

 Mu Sook Lee  ;  Man Deuk Kim  ;  Dae Chul Jung  ;  Myungsu Lee  ;  Jong Yun Won  ;  Sung Il Park  ;  Do Yun Lee  ;  Kwang-hun Lee 
 Journal of Vascular and Interventional Radiology, Vol.24(9) : 1361-1365, 2013 
Journal Title
 Journal of Vascular and Interventional Radiology 
Issue Date
Adult ; Diffusion Magnetic Resonance Imaging/methods* ; Female ; Humans ; Image Interpretation, Computer-Assisted/methods* ; Imaging, Three-Dimensional/methods* ; Leiomyoma/pathology* ; Middle Aged ; Observer Variation ; Prognosis ; Reproducibility of Results ; Sensitivity and Specificity ; Treatment Outcome ; Tumor Burden ; Uterine Artery Embolization/methods* ; Uterine Neoplasms/pathology* ; Uterine Neoplasms/therapy*
ADC ; DW ; ROC ; UAE ; VRR ; apparent diffusion coefficient ; diffusion-weighted ; receiver operating characteristic ; uterine artery embolization ; volume reduction rate
PURPOSE: To determine the utility of the apparent diffusion coefficient (ADC) of uterine leiomyoma for prediction of the potential response to uterine artery embolization (UAE). MATERIALS AND METHODS: This prospective study included 49 patients with uterine leiomyomas who underwent diffusion-weighted magnetic resonance (MR) imaging before UAE between May 2011 and January 2012. All patients also underwent 3-month follow-up MR imaging after UAE. Using conventional and diffusion-weighted MR imaging sequences, 72 uterine leiomyomas ≥ 3 cm were prospectively evaluated. The volume of each leiomyoma was calculated, and quantitative measurement of ADC was performed. Regression analysis was used to evaluate the relationship between ADC and volumetric response after UAE. Receiver operating characteristic curve analysis was performed to determine the sensitivity and specificity of ADC for prediction of the potential response to UAE. Interclass correlation coefficient analysis was used to assess interobserver variability between two radiologists. RESULTS: Volume reduction rates of leiomyomas after UAE ranged from 0.2%-89.1% (mean, 44.1%). ADC ranged from 0.559 × 10(-3) mm(2)/s to 1.814 × 10(-3) mm(2)/s (mean, 1.170 × 10(-3) mm(2)/s). ADC was statistically significantly related to volumetric response of leiomyomas (P = .014). Using a threshold of 1.092 × 10(-3) mm(2)/s, the sensitivity and specificity of ADC for prediction of > 50% volume reduction of the leiomyoma after UAE were 82.6% and 52.3%, respectively. Using a threshold of 1.023 × 10(-3) mm(2)/s, the sensitivity and specificity of ADC for prediction of < 30% volume reduction were 80.8% and 33.3%, respectively. The interclass correlation coefficient for measuring ADC of uterine leiomyomas between two radiologists was 0.98. CONCLUSIONS: ADC of uterine leiomyomas was significantly related to the volume reduction after UAE. ADC may be useful in predicting the potential response to UAE. A high ADC of the uterine leiomyoma may be associated with a greater volume reduction after UAE.
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1. College of Medicine (의과대학) > Dept. of Dermatology (피부과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Man Deuk(김만득) ORCID logo https://orcid.org/0000-0002-3575-5847
Park, Sung Il(박성일)
Won, Jong Yun(원종윤) ORCID logo https://orcid.org/0000-0002-8237-5628
Lee, Kwang Hoon(이광훈)
Lee, Do Yun(이도연)
Lee, Myung Su(이명수)
Jung, Dae Chul(정대철) ORCID logo https://orcid.org/0000-0001-5769-5083
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