This is a prospective study.
Main inclusion criteria were: symptomatic fibroids,
absence of any gynecologic surgery (including UAE) in anamnesis.
86 patients with uterine fibroids were included and randomized into two groups.
Group1 included 43 patients,
who underwent UAE with low-dose radiation protocol.
Group 2 included 42 patients (1 of 43 excluded during the study for co-morbidity) with standard radiation protocol.
Mean body mass index (BMI) in group 1 was 26,3,
and in group 2 mean BMI was 23,9.
Mean age in group 1 was 41,7 years,
and in group 2 it was 40,8 years.
Mean number of fibroids per patient in group one was 3,93,
whereas in group two it was 3,31.
Table 1.
Patient groups
|
Group 1
|
Group 2
|
P value
|
N of patients
|
43
|
42
|
|
Age,
years
|
41,7+6,6 (from 28 to 52)
|
40,8+5,4 (from 31 to 48)
|
0,6374
|
BMI
|
26,3+3,5
|
23,9+2,4
|
0,3024
|
N of fibroids per patient,
mean
|
3,93+2,14 (from 1 to 11)
|
3,31+1.94 (from 1 to 8)
|
0,1659
|
Standard radiation protocol included 6 acquisitions in digital subtraction mode (2 frames per second) and standard fluoroscopy in 7,5 frames per second mode.
Low-dose protocol consisted of 6 acquisitions in optimized native mode (4 frames per second) and reduced dose fluoroscopy 4 frames per second.
Radiation dose (dose-area product,
DAP,
mGym2) was measured with ionization chamber integrated into the collimator.
All procedures were performed by the same operator with stationary flat-detector angiographic system (Siemens Artis Zee floor).
In every procedure 6 acquisitions were performed.
Fluoroscopy time was not limited.
All UAEs were performed with right transfemoral approach.
Instrumental kit was standard for all procedures.
Every procedure was performed with calibrated microspheres sized from 500 to 900 mkm.
All patients in both groups underwent contrast-enhanced pelvic MRI before and three month after UFE.
Siemens Magnetom 3T system was used.
Before UFE size,
number and contrast perfusion of fibroids were measured.
Three month after the procedure non-perfused volume of fibroids was evaluated.
UFE was considered to be effective if all fibroids in one patient had non-perfused volume (NPV) 95% and more.
Table 2.
MRI-sequence,
used before and three month after UAE
Sequence
|
Plane
|
FOV
|
Matrix
|
Slice thickness
|
TE
|
TR
|
FA
|
T2TSE
|
axial,
coronal,
saggital
|
240x240
|
384x320
|
4
|
90
|
4000
|
150
|
T1-fl3D vibe pre contrast
|
axial
|
250x250
|
320x320
|
3
|
1.56
|
4.26
|
10
|
3D T2 space
|
axial
|
256x256
|
256x256
|
1
|
125
|
2000
|
120
|
Сontrast injection
|
T1 TWIST dynamic
|
axial
|
260x260
|
192x132
|
3.6
|
1.87
|
4.83
|
12
|
T1-fl3D vibe post contrast
|
axial
|
250x250
|
320x320
|
3
|
1.56
|
4.26
|
10
|
Statistical analysis was performed using the IBM SPSS 21 statistical software.
Obtained data were presented as mean + standard deviation.
Differences were analyzed using independent samples t-test,
and p-values less than 0.05 were considered significant.
For all patients informed consent was obtained.