title: Reduction in the vascular bed volume of uterine fibroids after hormonal treatment: evaluation with dynamic double-echo R₂* imaging.
abstract: OBJECTIVE
  To demonstrate the reduction in vascular bed volume (VBV) of uterine fibroids after administration of gonadotropin-releasing hormone analogue (GnRHa) using magnetic resonance (MR) imaging including dynamic double-echo R₂* imaging (DDE-R₂*I) and to assess the value of DDE-R₂*I as a predictor of such reduction.
  
  
  METHODS
  Twenty-one women with uterine intramural fibroids underwent MR imaging including DDE-R₂*I before GnRHa treatment. DDE-R₂*I was acquired using a single-section, double-echo, fast spoiled gradient recalled acquisition in the steady state (SPGR) sequence. We calculated the area under the curve (AUC) of the signal intensity on R₂*I within a 3×3-cm²region of interest that served to represent the VBV. We repeated MR imaging after 2 administrations of GnRHa and repeated image analyses. We statistically analyzed correlations between (A) pre-treatment AUC (AUC(pre)) and AUC reduction and (B) AUC(pre) and volume reduction.
  
  
  RESULTS
  The interval between the 2 MR studies ranged from 56 to 119 days (mean: 80.4 days). The average volume of the fibroids before GnRHa treatment was 647.8 mL compared with 463.4 mL after the therapy (decreased by an average of 28.5%; P<0.0001). Meanwhile, measured AUC was reduced by 55.3% (483.4 vs. 206.5; P<0.0001). AUC(pre) correlated with volume reduction (r=0.68), but not AUC reduction.
  
  
  CONCLUSIONS
  We confirmed reduction in the VBV of fibroids using DDE-R₂*I. The measurement of AUC(pre) on DDE-R₂*I aids prediction of fibroid volume reduction but correlates poorly with the percentage of AUC reduction.
authors.affiliation: Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo, Japan. okuda@rad.med.keio.ac.jp
authors.forename: Shigeo
authors.initials: S
authors.lastname: Okuda
authors.forename: Koichi
authors.initials: K
authors.lastname: Oshio
authors.forename: Hironori
authors.initials: H
authors.lastname: Asada
authors.forename: Akihiro
authors.initials: A
authors.lastname: Tanimoto
authors.forename: Masahiro
authors.initials: M
authors.lastname: Jinzaki
authors.forename: Masataka
authors.initials: M
authors.lastname: Furuya
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Yoshimura
authors.forename: Sachio
authors.initials: S
authors.lastname: Kuribayashi
mesh_terms: D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D019540:Area Under Curve; D003287:Contrast Media; D005260:Female; D005500:Follow-Up Studies; D019786:Gadolinium DTPA; D007987:Gonadotropin-Releasing Hormone / Q000627:therapeutic use; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007889:Leiomyoma / Q000098:blood supply* / Q000188:drug therapy*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000098:blood supply* / Q000188:drug therapy*; D014599:Uterus / Q000473:pathology; D055815:Young Adult
chemical_list: D018931:Antineoplastic Agents, Hormonal; D003287:Contrast Media; D007987:Gonadotropin-Releasing Hormone; C064925:gadodiamide; D019786:Gadolinium DTPA