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Impact of evaluation in interventional radiology clinic prior to uterine artery embolization: changes in management

  • Interventional Radiology
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To assess the impact of pre-procedural evaluation of patients with symptomatic uterine fibroids and adenomyosis in interventional radiology (IR) clinic.

Method

In this IRB-approved, HIPAA-compliant retrospective study, consecutive patients evaluated in the IR clinic in a tertiary academic hospital between 1/1/2015 and 9/30/2018 by a single board-certified interventional radiologist were included. Medical records were reviewed to obtain medical history, imaging and endometrial biopsies results. Impact of IR clinic assessment of clinical, imaging, and pathological findings on patient’s clinical course was assessed. Descriptive statistics were used.

Results

208 consecutive patients were evaluated in clinic for uterine fibroids 176/208 (85%), adenomyosis 8/208 (4%) or both 24/208 (11%) with age of 44.4 ± 5.8 years and BMI of 30.1 ± 8.6 kg/m2. Leading presenting symptom was menorrhagia in 172/208 (80%) patients, pelvic pain in 91/208 (44%), and urinary symptoms in 88/208 (42%) patients. 159/208 (76%) patients underwent UAE, 12/208 (6%) patients underwent surgery, and 37/208 (18%) patients chose conservative management. 189/208 (91%) patients had pelvic MRI that altered management course in 7/189 (4%) patients due to intracavitary fibroids in two patients, endometrial polyps in two patients, non-enhancing fibroids in two patients, and adnexal mass in one patient. 166/208 (80%) underwent endometrial biopsy that altered management course in one patient (0.6%) due to endometrial intraepithelial neoplasia.

Conclusion

Endometrial biopsy and pelvic MRI are helpful to detect cases of non-enhancing fibroids, intracavitary fibroids, and ovarian and endometrial malignancies and thus altered management of five percent of patients with symptomatic fibroids and adenomyosis.

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Abbreviations

UAE:

Uterine arterial embolization

IR:

Interventional radiology

CI:

Confidence interval

EIN:

Endometrial intraepithelial neoplasia

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Interventional Radiology, Department of Radiology, Beth Israel Deaconess Medical Center, 1 Deaconess Rd, Boston, MA, 02215, USA

    Masoud Nakhaei, Salomao Faintuch & Olga R. Brook

Authors
  1. Masoud Nakhaei
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  2. Salomao Faintuch
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  3. Olga R. Brook
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Correspondence to Olga R. Brook.

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Nakhaei, M., Faintuch, S. & Brook, O.R. Impact of evaluation in interventional radiology clinic prior to uterine artery embolization: changes in management. Abdom Radiol 45, 878–884 (2020). https://doi.org/10.1007/s00261-019-02388-3

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