Uterine Artery Embolization for Adenomyosis: Percentage of Necrosis Predicts Midterm Clinical Recurrence

Sohi Bae, Sohi H Bae, Bae SH, Man Deuk Kim, Kim MD, Kim GM, Gyoung Min Kim, Lee SJ, Shin Jae Lee, Park SI, Sung Il Park, Jong Yun Won, Do Yun Lee, Lee DY
Journal of vascular and interventional radiology : JVIR · 2015 · vol. 26(9) , pp. 1290–1296.e2 · doi:10.1016/j.jvir.2015.04.026 · PMID:26074028 · W1849486932
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-14 ⓘ

This study found that a necrosis percentage of 34.3% after uterine artery embolization predicts midterm symptom recurrence in adenomyosis patients.

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This retrospective study evaluated 50 women with symptomatic adenomyosis who underwent uterine artery embolization (UAE), assessing the relationship between MRI-measured post-UAE necrosis percentage and symptom recurrence over at least 18 months (18–48 months). Contrast-enhanced MRI was performed at baseline and 3 months after UAE, with necrosis quantified three-dimensionally and adenomyosis classified as focal or diffuse; a necrosis cutoff for predicting recurrence was estimated and recurrence rates compared, with risk factors analyzed. Symptom recurrence occurred in 12/50 patients, and a necrosis cutoff of 34.3% (AUC 0.721, 95% CI 0.577–0.839, P = .004) predicted recurrence, with patients having <34.3% necrosis showing a significantly higher recurrence risk (hazard ratio 7.0, 95% CI 2.2–22.4, P = .001). Initial uterine volume and adenomyosis type were not associated with recurrence. This paper is centrally about endometriosis — it focuses on adenomyosis and uses UAE necrosis percentage to predict midterm symptom recurrence, directly relating to adenomyosis.

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Abstract

PurposeTo evaluate the effect of degree of necrosis after uterine artery embolization (UAE) on symptom recurrence at midterm clinical follow-up in patients with adenomyosis.Materials and methodsWomen (N = 50) who underwent UAE for symptomatic adenomyosis were retrospectively analyzed. All patients underwent contrast-enhanced magnetic resonance (MR) imaging at baseline and 3 months after UAE and were followed clinically for at least 18 months. The type of adenomyosis was classified as focal or diffuse. The uterine volume and the percentage of necrosis after embolization were measured three-dimensionally on MR imaging. The percentage of the necrosis cutoff point for predicting recurrence was estimated. Patients were divided into 2 groups according to the cutoff point. The rate of recurrence was compared between groups, and risk factors for recurrence were identified.ResultsDuring the follow-up period (range, 18-48 mo), symptom recurrence occurred in 12 of 50 patients. A necrosis cutoff point of 34.3% was calculated to predict recurrence (area under the curve = 0.721; 95% confidence interval [CI] = 0.577-0.839; P = .004). Patients with 34.3% necrosis (group B, n = 38; hazard ratio = 7.0; 95% CI = 2.2, 22.4; P = .001). Initial uterine volume and type of adenomyosis were not associated with recurrence.ConclusionsThe percentage of necrosis in patients with adenomyosis after UAE may predict symptom recurrence at midterm follow-up. The cutoff percentage of necrosis required to predict symptom recurrence was 34.3% in this study.
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Materials and methods

Women (N = 50) who underwent UAE for symptomatic adenomyosis were retrospectively analyzed. All patients underwent contrast-enhanced magnetic resonance (MR) imaging at baseline and 3 months after UAE and were followed clinically for at least 18 months. The type of adenomyosis was classified as focal or diffuse. The uterine volume and the percentage of necrosis after embolization were measured three-dimensionally on MR imaging. The percentage of the necrosis cutoff point for predicting recurrence was estimated. Patients were divided into 2 groups according to the cutoff point. The rate of recurrence was compared between groups, and risk factors for recurrence were identified.

Results

During the follow-up period (range, 18-48 mo), symptom recurrence occurred in 12 of 50 patients. A necrosis cutoff point of 34.3% was calculated to predict recurrence (area under the curve = 0.721; 95% confidence interval [CI] = 0.577-0.839; P = .004). Patients with 34.3% necrosis (group B, n = 38; hazard ratio = 7.0; 95% CI = 2.2, 22.4; P = .001). Initial uterine volume and type of adenomyosis were not associated with recurrence.

Conclusions

The percentage of necrosis in patients with adenomyosis after UAE may predict symptom recurrence at midterm follow-up. The cutoff percentage of necrosis required to predict symptom recurrence was 34.3% in this study. - Appears in Collections: - 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

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Condition tags

adenomyosis

MeSH descriptors

Adenomyosis Adenomyosis Menorrhagia Postoperative Complications Uterine Artery Embolization Uterus Adenomyosis Adenomyosis Adult Comorbidity Female Follow-Up Studies Humans Menorrhagia Menorrhagia Middle Aged Necrosis Postoperative Complications Postoperative Complications Prevalence

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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