Semiquantitative assessment of MR imaging in prediction of efficacy of gonadotropin-releasing hormone agonist for volume reduction of uterine leiomyoma: initial experience.
OBJECTIVE
To prospectively determine if semiquantitative assessment of R2* images and T1-weighted magnetic resonance (MR) images of leiomyomas correlates with the efficacy of gonadotropin-releasing hormone (GnRH) agonist treatment for volume reduction.


METHODS
Internal review board approval and informed consent were obtained for this study. Twenty women (mean age, 36.3 years) with intramyometrial leiomyomas were enrolled in this study. Single-section double-echo dynamic MR imaging was performed before GnRH agonist administration. T2-weighted images were obtained before and after two or three GnRH agonist injections (1.88 mg leuprorelin acetate). The steepest signal intensity (SI) upslope on T1-weighted images and the area under the curve (AUC) on R2* images were determined by using a 16 x 16-voxel matrix that was placed in the center of a leiomyoma. Pearson correlation analysis was performed to compare the percentage of volume reduction with SI upslope and AUC. Unpaired t test was performed to evaluate the difference between leiomyomas with AUC and SI upslope values that were less than or greater than the mean.


RESULTS
Percentage of volume reduction ranged from 6.2% to 51.1%. The mean AUC and mean SI upslope were 39.2 and 9.83% per second, respectively. There was a significant correlation between the AUC and the percentage of volume reduction (r = 0.81, P < .001), although no significant correlation was observed between the SI upslope and the percentage of volume reduction. A significant difference in percentage of volume reduction was observed in leiomyomas by using mean AUC as a cutoff value (P = .003).


CONCLUSIONS
AUC on R2* images correlates with the efficacy of GnRH agonist before initiation of treatment for volume reduction of leiomyoma.
Okuda
Shigeo
S
Department of Diagnostic Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo 160-8582, Japan. okuda@sc.itc.keio.ac.jp
Oshio
Koichi
K
Shinmoto
Hiroshi
H
Tanimoto
Akihiro
A
Asada
Hironori
H
Fujii
Takuma
T
Yoshimura
Yasunori
Y
Kuribayashi
Sachio
S
D000328:Adult; D000465:Algorithms; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007889:Leiomyoma / Q000175:diagnosis* / Q000188:drug therapy*; D016729:Leuprolide / Q000008:administration & dosage*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D010865:Pilot Projects; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000188:drug therapy*
D018931:Antineoplastic Agents, Hormonal; D007987:Gonadotropin-Releasing Hormone; D016729:Leuprolide