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Leiomyoma Volume Changes at Follow-up after Uterine Artery Embolization: Correlation with the Initial Leiomyoma Volume and Location

Nagy N.N. Naguib, MScCorresponding Author Informationemail address, Emmanuel Mbalisike, MBBCh, Nour-Eldin A. Nour-Eldin, MSc, Alexandra Jost, MED, Thomas Lehnert, MD, Hans Ackermann, MD, Thomas J. Vogl, MD

Received 29 January 2009; received in revised form 8 November 2009; accepted 1 December 2009. published online 09 February 2010.
Corrected Proof

PURPOSE

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.

MATERIALS AND METHODS

The study was performed retrospectively on 28 consecutive patients (age, 37–57 years; mean, 48 y ± 4.81) with 84 uterine leiomyomas. UAE was performed between June 2006 and August 2007. All tumors in all patients were evaluated. Magnetic resonance imaging was performed before UAE and 3 months and 1 year after UAE. The volume and location of each tumor were evaluated in consensus by two radiologists.

RESULTS

The mean pre-UAE volume of the leiomyomas was 51.6 cm3 (range, 0.72–371.1 cm3; 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.

CONCLUSIONS

UAE results in leiomyoma volume reduction at 3-month and 1-year follow-up. The tumor location plays an important role in volume changes and the initial tumor volume plays a minor role. Further studies with larger numbers of submucous leiomyomas are needed.

Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Hessen 60590, Germany.

Corresponding Author InformationAddress correspondence to N.N.N.N.

 None of the authors have identified a conflict of interest.

PII: S1051-0443(09)01659-5

doi:10.1016/j.jvir.2009.12.388