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Efficacy of uterine artery embolization (UAE) for uterine fibroids according to FIGO classification: a single-center experience

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Abstract

Objective

This study aims to retrospectively evaluate the outcomes of uterine artery embolization (UAE) for uterine fibroids (UFs), specifically submucosal UFs, according to the International Federation of Gynecology and Obstetrics (FIGO) classification of UFs.

Materials and methods

Forty-two patients with symptomatic UFs underwent UAE with Embosphere® between July 2016 and November 2021. MRI was performed before, at 3 and 6 months after the UAE. At each examination, the volume of UF was measured, and the percentage volume reduction rate (VRR) was calculated. The technical success rate (TSR), symptom improvement rate (SIR), regrowth rate (RR) after 6 months, and adverse events (AEs) were examined; VRR was compared between patients with submucosal UFs (FIGO types 0–2, group A), those with submucosal contacts (FIGO type 3, group B), and those without submucosal UFs (FIGO types 4–7, group C). Statistical analysis was performed on the difference in VRR between groups A, B, and C at 3 and 6 months after UAE. The relationship with hormone levels before UAE and VRR was evaluated.

Results

Thirty-seven of the 42 patients were evaluated. Overall, VRR was 37.0% at 3 months and 52.1% at 6 months; TSR, SIR, and RR were 100%, 95.2%, and 5.4%, respectively; VRR at 6 months was 80.7% for group A (n = 7), 57.8% for group B (n = 13), and 37.1% for group C (n = 17). Significant differences were found between A and C (p < 0.001) and B and C (p = 0.023). Hormone levels before UAE had no effect on VRR. There was no significant AEs other than grade 3 pulmonary embolism in one patient.

Conclusion

UAE was effective for submucosal FIGO types 0–3. UAE was especially useful as an option for FIGO type 3 with a low protrusion rate that is difficult to treat with transcervical resection.

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Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-Ku, Tokyo, Japan

    Hiroe Ito, Takayuki Kikuchi & Yuta Kinoshita

  2. Department of Radiology, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-Ku, Tokyo, Japan

    Motoki Nakai, Daisuke Yunaiyama, Natsuhiko Shirota, Takehiro Kobayashi, Mika Yasutomi, Yuki Takara, Taro Tanaka, Toru Saguchi & Kazuhiro Saito

Authors
  1. Hiroe Ito
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  2. Motoki Nakai
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  3. Daisuke Yunaiyama
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  4. Natsuhiko Shirota
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  5. Takehiro Kobayashi
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  6. Mika Yasutomi
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  7. Takayuki Kikuchi
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  8. Yuta Kinoshita
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  10. Taro Tanaka
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  11. Toru Saguchi
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  12. Kazuhiro Saito
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Contributions

All authors have contributed significantly to the study conception and design. HI and MN had the idea for the article and the literature search. The first draft of the manuscript was written by HI and edited by MN.

Corresponding author

Correspondence to Motoki Nakai.

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The authors declare that they have no conflicts of interest and nothing to disclose.

Ethical approval

For this type of study, formal consent is not required. The study was approved by the Institutional Review Board of Tokyo Medical University Hospital (T2020-0102).

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Ito, H., Nakai, M., Yunaiyama, D. et al. Efficacy of uterine artery embolization (UAE) for uterine fibroids according to FIGO classification: a single-center experience. Jpn J Radiol 42, 174–181 (2024). https://doi.org/10.1007/s11604-023-01492-1

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  • DOI: https://doi.org/10.1007/s11604-023-01492-1

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