MRI Determines Treatment for Fibroids

Uterine fibroids are very common benign growths that develop in the muscular wall of the uterus in up to 40% of women age 35 and older. Research also showed interventional radiologists can use MRI scans to determine if a tumor can be embolized, identify other causes for the symptoms, detect pathology that could prevent a women from having UFE and thereby avoid ineffective treatments.

"Using an MRI rather than ultrasound is like listening to a digital CD rather than a record--the quality is better in every way,” stated interventional radiologist and study author Howard B. Chrisman, M.D., of Northwestern University Feinberg School of Medicine (Chicago, IL, USA). "With an MRI we can clearly delineate the location of each fibroid, determine if it's viable for treatment non-surgically, rule out misdiagnosis, identify which treatments are best suited for each patient and avoid ineffective treatments.”

In the study, 100 consecutive women referred to Northwestern University Feinberg School of Medicine for the treatment of symptomatic uterine fibroids were evaluated. Of these women, 94 underwent MRI scans that revealed 381 leiomyomas (fibroids). Based on their MRI results, 21 patients did not undergo embolization to treat the uterine fibroids. In these cases, interventional radiologist used MR images to determine embolization would not be appropriate for the patient, because of biologic factors such as nonviable tumors (tumors lacking adequate blood flow for an embolization), uterus size, and presence of isolated adenomyosis and endometrial lesions. Sixty-eight patients (72%) underwent uterine fibroid embolization.

UFE, also known as uterine artery embolization, is performed by an interventional radiologist or a surgeon. Interventional radiologists utilize imaging modalities to first determine, visualize, and diagnose the pathology and to map out the procedure, customizing it to the individual patient. Then during the procedure, they image in real-time, literally watching and guiding their catheter inside an artery to the site of the problem. This method allows interventional radiologists to deliver targeted treatments directly to the disease non-surgically.

To perform a UFE, the interventional radiologist makes a small cut in the skin in the groin and inserts a catheter into the femoral artery. Using real-time imaging, the radiologist guides the catheter through the artery and then releases tiny particles into the uterine arteries that supply blood to the fibroid tumor. This blocks the blood flow to the fibroid tumor causing it to shrink and die.




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Northwestern University Feinberg School of Medicine