Although the biological characteristics of uterine fibroids (UF) have implications for therapy choice and effectiveness, there is limited MRI data about these characteristics. Currently, the Funaki classification and Scaled Signal Intensity (SSI) are used to predict treatment outcome but both screening-tools appear to be suboptimal. Therefore, multiparametric and quantitative MRI was studied to evaluate various biological characteristics of UF.
87 patients with UF underwent an MRI-examination. Differences between UF tissues and myometrium were investigated using T2-mapping, Apparent Diffusion Coefficient (ADC) maps with different b-value combinations, contrast-enhanced T1-weighted and T2-weighted imaging. Additionally, the Funaki classification and SSI were calculated.
Significant differences between myometrium and UF tissue in T2-mapping (p = 0.001), long-TE ADC low b-values (p = 0.002), ADC all b-values (p < 0.001) and high b-values (p < 0.001) were found. Significant differences between Funaki type 3 versus type 1 and 2 were observed in SSI (p < 0.001) and T2-values (p < 0.001). Significant correlations were found between SSI and T2-mapping (p < 0.001; ρs = 0.82), ADC all b-values (p = 0.004; ρs = 0.31), ADC high b-values (p < 0.001; ρs = 0.44) and long-TE ADC low b-values (p = 0.004; ρs = 0.31).
Quantitative MR-data allowed us to distinguish UF tissue from myometrium and to discriminate different UF tissue types and may, therefore, be a useful tool to predict treatment outcome/determine optimal treatment modality.
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Apparent diffusion coefficient
Magnetic resonance image guided-high intensity focused ultrasound
Magnetic resonance imaging
Scaled signal intensity
Transformed symptom severity score
Transformed health-related quality of life
Uterine artery embolization
Uterine fibroid symptom health-related quality of life questionnaire
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This research was made possible with financial support from the Innovation and Science fund of Isala Hospital in Zwolle, the Netherlands.
Conflict of interest
Authors E. Heijman and P.C. Vos are both employees of Philips who have developed the MR-HIFU equipment. All other authors had no financial interest or conflicts of interest in the subject matter discussed in the submitted manuscript. All authors state that this study complies with the Declaration of Helsinki.
All authors state that this study complies with the Declaration of Helsinki.
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Verpalen, I.M., Anneveldt, K.J., Vos, P.C. et al. Use of multiparametric MRI to characterize uterine fibroid tissue types. Magn Reson Mater Phy 33, 689–700 (2020). https://doi.org/10.1007/s10334-020-00841-9
- Uterine fibroids
- High-intensity focused ultrasound ablation
- Magnetic resonance imaging
- Diffusion MRI