Diffusion-weighted imaging properties of uterine fibroids pre- and post-uterine fibroid embolisation

Monitoring Leiomyoma Response to Uterine Artery Embolization Using Diffusion and Perfusion Indices from Diffusion-Weighted Imaging

“…DWI (together with quantitative ADC map) is a rapidly evolving technique with potential to characterize tissue cellularity and cell membrane integrity [ 21 ]. In our study, a significant increase in ADC value occurred in fibroids treated with UAE, which is in agreement with the result of a recent study [ 12 ]. Kirpalani et al showed that the pre- and post-UAE ADCs at 1.5 T were 1.30 and 1.68 × 10 -3 mm 2 /s at 6-month follow-up and they were significantly different ( P < 0.0001) [ 12 ].…”

“…In our study, a significant increase in ADC value occurred in fibroids treated with UAE, which is in agreement with the result of a recent study [ 12 ]. Kirpalani et al showed that the pre- and post-UAE ADCs at 1.5 T were 1.30 and 1.68 × 10 -3 mm 2 /s at 6-month follow-up and they were significantly different ( P < 0.0001) [ 12 ]. This presumably reflects a loss of cellularity, membrane integrity, and extracellular space expansion resulting from cell necrosis after embolization.…”

“…As pointed out in the limitation of the previous studies [ 10 – 12 ], the simplified monoexponential algorithm for ADC calculation lacks accuracy in depicting the tissue characteristics of fibroids because the diffusion-weighted signal combines both diffusion and perfusion effects according to the IVIM theory [ 13 ]. In human tissues, diffusion-weighted data obtained with low b -values (<200 s/mm 2 ) are more sensitive to perfusion effect, whereas data obtained with high b -values (>200 s/mm 2 ) predominantly account for diffusion effect [ 23 ].…”

“…By measuring the diffusion-weighted signal attenuation at two or more b -values (a combination of diffusion gradient strength and pulse duration), quantitative data such as apparent diffusion coefficient (ADC) can be yielded. Several studies have shown that ADC may be a useful imaging marker to monitor the treatment response after UAE on 1.5-T MRI platforms [ 9 – 12 ]. However, the previous studies produced contradictory results, particularly in terms of whether post-UAE ADC increases or decreases compared with baseline measurement [ 9 – 12 ] ( Table 1 ).…”

“…Several studies have shown that ADC may be a useful imaging marker to monitor the treatment response after UAE on 1.5-T MRI platforms [ 9 – 12 ]. However, the previous studies produced contradictory results, particularly in terms of whether post-UAE ADC increases or decreases compared with baseline measurement [ 9 – 12 ] ( Table 1 ). Additionally, to our knowledge, no previous data have been published at 3.0-T MRI until now.…”