title: Diffusion-weighted imaging properties of uterine fibroids pre- and post-uterine fibroid embolisation.
abstract: OBJECTIVE
  To determine the change in apparent diffusion coefficient (ADC) of uterine fibroids following uterine fibroid embolisation (UFE), and if the ADC change correlates with either volume loss or degree of contrast enhancement post-UFE.
  
  
  METHODS
  This study was approved by our institutional review board with waiver of consent. The pelvic MRI examinations, including diffusion-weighted MRI (DWI) using 4 b-values, of 50 consecutive patients prior to and 6 months post-UFE were analyzed. The volume, ADC and amount of enhancement were calculated for each fibroid both pre- and post-UFE. The percent residual enhancement for each fibroid was categorized as either: no (0-1%) residual enhancement or residual (>1%) enhancement. Statistical analysis compared ADC, enhancement and volume for each fibroid pre- and post-UFE using paired t-tests and Pearson correlation coefficients.
  
  
  RESULTS
  The mean ADC of all (n=88) fibroids pre-UFE was 1.30±0.20×10(-3)mm(2)/s, and increased to 1.68±0.24×10(-3)mm(2)/s post-UFE (p<0.0001). Lower pre-UFE ADC correlated with greater ADC change post-UFE (r=-0.50; p<0.0001). There was no correlation between ADC change and volume change post-UFE (r=0.07; p=0.59). However, fibroids with no residual enhancement post-UFE had larger ADC change than those with residual enhancement (p=0.003).
  
  
  CONCLUSIONS
  The ADC of fibroids rises post-UFE. ADC change post-UFE is associated with the degree of loss of enhancement and may therefore be valuable in predicting response to treatment in pre-procedural counseling.
authors: Department of Medical Imaging, University of Toronto, St. Michael's Hospital, 30 Bond Street, 3CC, Toronto, ON M5B 1W8, Canada. Electronic address: kirpalania@smh.ca.
authors: Anish
authors: A
authors: Kirpalani
authors: Department of Medical Imaging, University of Toronto, St. Michael's Hospital, 30 Bond Street, 3CC, Toronto, ON M5B 1W8, Canada.
authors: Jennifer
authors: J
authors: Chong
authors: Department of Radiology, Austin Health, Heidelberg, Victoria 3084, Australia.
authors: Natalie
authors: N
authors: Yang
authors: Department of Radiology, Memorial University of Newfoundland, St. John's, NL A1B 3V6, Canada.
authors: Sarah J
authors: SJ
authors: Jenkins
authors: Centre for Research on Inner City Health, the Keenan Research Centre in the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Dalla Lana School of Public Health, University of Toronto, 30 Bond Street, Toronto, ON M5B 1W8, Canada.
authors: Rosane
authors: R
authors: Nisenbaum
authors: Department of Medical Imaging, University of Toronto, St. Michael's Hospital, 30 Bond Street, 3CC, Toronto, ON M5B 1W8, Canada.
authors: Vikramaditya
authors: V
authors: Prabhudesai
authors: Department of Medical Imaging, University of Toronto, St. Michael's Hospital, 30 Bond Street, 3CC, Toronto, ON M5B 1W8, Canada.
authors: Shalini
authors: S
authors: Anthwal
authors: Department of Medical Imaging, University of Toronto, St. Michael's Hospital, 30 Bond Street, 3CC, Toronto, ON M5B 1W8, Canada.
authors: Errol
authors: E
authors: Colak
mesh_terms: D000328:Adult; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007889:Leiomyoma / Q000175:diagnosis* / Q000628:therapy*; D008536:Meglumine / Q000031:analogs & derivatives; D008875:Middle Aged; D009942:Organometallic Compounds; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D014599:Uterus / Q000473:pathology
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine
keywords: ADC; Diffusion weighted imaging; Embolization; Fibroid; MRI