Treatment-related changes in adenomyosis: a primer for radiologists

Adenomyosis is a common, estrogen-dependent condition where endometrial tissue grows within the myometrium, often accompanied by smooth muscle hypertrophy. Initially thought to represent a condition primarily seen in multiparas with menorrhagia, and dysmenorrhea, adenomyosis is now increasingly recognized in younger patients and those with infertility and subfertility. As a result, conservative treatments aimed at preserving the uterus and improving reproductive outcomes have gained attention to treat adenomyosis. While research has largely focused on managing abnormal uterine bleeding and dysmenorrhea, there is limited evidence on the treatment of infertility associated with adenomyosis, particularly in terms of imaging follow-up. This paper reviews the emerging literature, highlighting key imaging findings before and after uterus-preserving treatments for adenomyosis, to better inform management and decision-making. Graphical Abstract Similar content being viewed by others Data availability No datasets were generated or analysed during the current study.

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The authors would like to thank Maria Clara Gomes Cabral de Souza for the illustrations and Alice Brandão, MD, and Marco Aurélio Pinho de Oliveira, MD, for kindly providing images used in this paper. Author information Authors and Affiliations Contributions B.C.O. and L.P.C. structured the outline.B.C.O., M.K.F., P.J., and S.Y. wrote the main manuscript.B.C.O. prepared all figures.P.J., A.S.C., and L.P.C. reviewed the manuscript. Corresponding authors Ethics declarations Competing interests The authors declare no competing interests. Additional information Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. About this article Cite this article Oliveira, B., Feldman, ., Jha, P. et al. Treatment-related changes in adenomyosis: a primer for radiologists. Abdom Radiol 50, 4359–4373 (2025). https://doi.org/10.1007/s00261-025-04866-3 Received: Revised: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s00261-025-04866-3