Magnetic resonance imaging and serum CA-125 in evaluating patients with endometriomas prior to medical therapy

OBJECTIVE: To determine whether magnetic resonance imaging (MRI) and serum levels of CA-125 can be used to evaluate patients with endometriomas before initiating medical treatment. DESIGN: Comparative study before and after medical treatment. SETTING: Shimane Medical University Hospital, Izumo, Japan. PATIENTS: Eleven consecutive patients with at least one endometrioma > 10 mm in maximal diameter that was diagnosed by laparoscopy and treated with 900 micrograms/d buserelin acetate for 6 months. INTERVENTIONS: Magnetic resonance imaging and blood sampling was performed < 2 weeks before laparoscopy. MAIN OUTCOME MEASURES: Signal intensity of edometrioma/signal intensity of gluteus maximum muscle on T2-weighted image (T2SI:MSI); volume of endometrioma and serum CA-125. RESULTS: There was a positive linear correlation (r = 0.787) between T2SI:MSI before treatment and the extent of decrease in the volume of endometrioma. There was a negative linear relationship between serum CA-125 before treatment and the mean extent of decrease in the cyst volume (r = 0.678). The reduction in volume of endometrioma and T2SI:MSI before treatment related to the outcome of patients. CONCLUSION: The T2SI:MSI on MRI and serum CA-125 may be useful for estimating the outcome of patients with endometriomas before initiating medical treatment.