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

Purpose. To investigate the potential of diffusion and perfusion indices (ADC and perfusion fraction ) from DWI at 3.0 T in monitoring treatment response to uterine artery embolization (UAE) at 6-month follow-up. Methods. Twelve female patients with uterine fibroids who underwent 3.0-T pelvic DWI before and 6 months after UAE were included. ADC and perfusion fraction were calculated from DWI. The Wilcoxon signed-rank test and Spearman rank correlation test were used for statistics. Results. Seventeen fibroids were studied. The median ADCs showed a significant increase from 1.20 × 10−3 mm2/s (range, 0.86–1.66 × 10−3 mm2/s) at baseline to 1.56 × 10−3 mm2/s (range, 1.00–1.86 × 10−3 mm2/s) at 6-month follow-up (). Conversely, the median perfusion fraction was significantly decreased after UAE (), with a median pre-UAE value of 14.2% (range, 6.7%–17.6%) and a median post-UAE value of 9.2% (range, 3.2%–14.6%). Significant correlations were found between fibroid volume reduction rate and percentage changes in ADC and perfusion fraction at 6-month follow-up relative to baseline, with values of −0.50 () and 0.55 (), respectively. Conclusion. ADC and perfusion fraction obtained from DWI at 3.0 T may help to evaluate treatment response to UAE.

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