Volume of embolic agents in uterine artery embolization for leiomyoma: relation to baseline MRI

Purpose: To assess whether pre-procedural MRI findings predict the volume of tris-acryl gelatin microspheres (TAGM) used in uterine artery embolization (UAE) for leiomyomas. Material and methods: This was a retrospective, single-institution study. Between June 2014 and December 2017, 73 patients with leiomyomas underwent UAE with TAGM alone. Univariate and multivariate analyses were performed to assess the relationships between the volume of TAGM and baseline parameters. Technical outcomes, tumor infarction on post-procedural contrast-enhanced MRI, and complications were evaluated. Results: Technical success was achieved in all patients. Infarction of >= 90% of the total leiomyoma volume was observed in 93% (67/72) of patients. No major complications were noted. The mean (SD) volume of 500- to 700-mu m particles used in all (73/73) patients was 10.3 +/- 4.6 ml. The multivariate analysis revealed that uterine volume (p = .034) correlated with the 500- to 700-mu m TAGM volume. Seven hundred- to 900-mu m particles were added for 70% (51/73) of patients at a mean (SD) volume of 3.6 +/- 4.6 ml. The dominant tumor volume (p = .028) correlated with the 700- to 900-mu m TAGM volume. Conclusion: The dominant tumor or uterine volume on pre-procedural MRI was directly associated with the volume of TAGM required for embolization of leiomyomas.