title: Three-Dimensional Quantitative Assessment of Uterine Fibroid Response after Uterine Artery Embolization Using Contrast-Enhanced MR Imaging.
abstract: OBJECTIVE
  To evaluate the clinical feasibility and diagnostic accuracy of three-dimensional (3D) quantitative magnetic resonance (MR) imaging for the assessment of total lesion volume (TLV) and enhancing lesion volume (ELV) before and after uterine artery embolization (UAE).
  
  
  METHODS
  This retrospective study included 25 patients with uterine fibroids who underwent UAE and received contrast-enhanced MR imaging before and after the procedure. TLV was calculated using a semiautomated 3D segmentation of the dominant lesion on contrast-enhanced MR imaging, and ELV was defined as voxels within TLV where the enhancement exceeded the value of a region of interest placed in hypoenhancing soft tissue (left psoas muscle). ELV was expressed in relative (% of TLV) and absolute (in cm(3)) metrics. Results were compared with manual measurements and correlated with symptomatic outcome using a linear regression model.
  
  
  RESULTS
  Although 3D quantitative measurements of TLV demonstrated a strong correlation with the manual technique (R(2) = 0.93), measurements of ELV after UAE showed significant disagreement between techniques (R(2) = 0.72; residual standard error, 15.8). Six patients (24%) remained symptomatic and were classified as nonresponders. When stratified according to response, no difference in % ELV between responders and nonresponders was observed. When assessed using cm(3) ELV, responders showed a significantly lower mean ELV compared with nonresponders (4.1 cm(3) [range, 0.3-19.8 cm(3)] vs 77 cm(3) [range, 11.91-296 cm(3)]; P < .01).
  
  
  CONCLUSIONS
  The use of segmentation-based 3D quantification of lesion enhancement is feasible and diagnostically accurate and could be considered as an MR imaging response marker for clinical outcome after UAE.
authors: Russell H. Morgan Department of Radiology and Radiological Science, Division of Vascular and Interventional Radiology, The Johns Hopkins Hospital, Sheikh Zayed Tower, Suite 7203, 1800 Orleans Street, Baltimore, MD 21287; Department of Diagnostic and Interventional Radiology, Charité Universitätsmedizin, Berlin, Germany.
authors: Julius
authors: J
authors: Chapiro
authors: Russell H. Morgan Department of Radiology and Radiological Science, Division of Vascular and Interventional Radiology, The Johns Hopkins Hospital, Sheikh Zayed Tower, Suite 7203, 1800 Orleans Street, Baltimore, MD 21287.
authors: Rafael
authors: R
authors: Duran
authors: Clinical Informatics, Interventional, and Translational Solutions, Philips Research North America, Briarcliff Manor, New York.
authors: MingDe
authors: M
authors: Lin
authors: Russell H. Morgan Department of Radiology and Radiological Science, Division of Vascular and Interventional Radiology, The Johns Hopkins Hospital, Sheikh Zayed Tower, Suite 7203, 1800 Orleans Street, Baltimore, MD 21287.
authors: John D
authors: JD
authors: Werner
authors: Russell H. Morgan Department of Radiology and Radiological Science, Division of Vascular and Interventional Radiology, The Johns Hopkins Hospital, Sheikh Zayed Tower, Suite 7203, 1800 Orleans Street, Baltimore, MD 21287.
authors: Zhijun
authors: Z
authors: Wang
authors: Russell H. Morgan Department of Radiology and Radiological Science, Division of Vascular and Interventional Radiology, The Johns Hopkins Hospital, Sheikh Zayed Tower, Suite 7203, 1800 Orleans Street, Baltimore, MD 21287.
authors: Rüdiger
authors: R
authors: Schernthaner
authors: Russell H. Morgan Department of Radiology and Radiological Science, Division of Vascular and Interventional Radiology, The Johns Hopkins Hospital, Sheikh Zayed Tower, Suite 7203, 1800 Orleans Street, Baltimore, MD 21287; Department of Diagnostic and Interventional Radiology, Charité Universitätsmedizin, Berlin, Germany.
authors: Lynn Jeanette
authors: LJ
authors: Savic
authors: Russell H. Morgan Department of Radiology and Radiological Science, Division of Vascular and Interventional Radiology, The Johns Hopkins Hospital, Sheikh Zayed Tower, Suite 7203, 1800 Orleans Street, Baltimore, MD 21287.
authors: Mark L
authors: ML
authors: Lessne
authors: Russell H. Morgan Department of Radiology and Radiological Science, Division of Vascular and Interventional Radiology, The Johns Hopkins Hospital, Sheikh Zayed Tower, Suite 7203, 1800 Orleans Street, Baltimore, MD 21287.
authors: Jean-François
authors: JF
authors: Geschwind
authors: Russell H. Morgan Department of Radiology and Radiological Science, Division of Vascular and Interventional Radiology, The Johns Hopkins Hospital, Sheikh Zayed Tower, Suite 7203, 1800 Orleans Street, Baltimore, MD 21287. Electronic address: khong1@jhmi.edu.
authors: Kelvin
authors: K
authors: Hong
mesh_terms: D000328:Adult; D003287:Contrast Media; D004621:Embolization, Therapeutic / Q000379:methods; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007889:Leiomyoma / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies; D055988:Uterine Artery; D014594:Uterine Neoplasms / Q000473:pathology*
chemical_list: D003287:Contrast Media
references: J Vasc Interv Radiol. 2006 Dec;17(12):1923-9
references: 17185687
references: Radiology. 2013 Mar;266(3):812-21
references: 23220891
references: Lancet. 1995 Sep 9;346(8976):671-2
references: 7544859
references: Eur J Radiol. 2012 May;81(5):e727-31
references: 22381440
references: Obstet Gynecol. 2008 Jan;111(1):22-33
references: 18165389
references: Cardiovasc Intervent Radiol. 2008 Jan-Feb;31(1):66-72
references: 17943351
references: J Vasc Interv Radiol. 2012 Dec;23(12):1629-37
references: 23177109
references: Radiology. 2002 Jan;222(1):45-52
references: 11756703
references: Radiology. 2008 Mar;246(3):823-32
references: 18187401
references: Radiographics. 2012 Oct;32(6):E251-81
references: 23065174
references: Radiographics. 2012 Oct;32(6):1735-50
references: 23065167
references: Radiology. 2003 Jan;226(1):24-8
references: 12511664
references: Obstet Gynecol. 2008 Aug;112(2 Pt 1):387-400
references: 18669742
references: Acad Radiol. 2013 Apr;20(4):446-52
references: 23498985
references: J Vasc Interv Radiol. 2005 Aug;16(8):1143-7
references: 16105928
references: Radiology. 2010 Jun;255(3):834-41
references: 20392986
references: J Vasc Interv Radiol. 2013 Jun;24(6):765-71
references: 23582992
references: Radiology. 2002 Feb;222(2):367-74
references: 11818601
references: Cardiovasc Intervent Radiol. 2011 Aug;34(4):705-16
references: 21085962
references: Radiology. 2004 Mar;230(3):803-9
references: 14990844
references: Value Health. 2012 Jan;15(1):135-42
references: 22264981
references: J Vasc Interv Radiol. 2009 Jul;20(7 Suppl):S193-9
references: 19559999
references: Acta Radiol. 2014 May;55(4):441-9
references: 23943627
references: J Magn Reson Imaging. 2011 Mar;33(3):641-6
references: 21563247
references: Acad Radiol. 2013 Jan;20(1):115-21
references: 22947274