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European Radiology
Published in: European Radiology 9/2014

01-09-2014 | Interventional

Diffusion-weighted magnetic resonance imaging using different b-value combinations for the evaluation of treatment results after volumetric MR-guided high-intensity focused ultrasound ablation of uterine fibroids

Authors: Marlijne E. Ikink, Marianne J. Voogt, Maurice A. A. J. van den Bosch, Robbert J. Nijenhuis, Bilgin Keserci, Young-sun Kim, Koen L. Vincken, Lambertus W. Bartels

Published in: European Radiology | Issue 9/2014

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Abstract

Objectives

To assess the value of diffusion-weighted magnetic resonance imaging (DWI) and apparent diffusion coefficient (ADC) mapping using different b-value combinations for treatment evaluation after magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) of uterine fibroids.

Methods

Fifty-six patients with 67 uterine fibroids were treated with volumetric MR-HIFU. Pre-treatment and post-treatment images were obtained using contrast-enhanced T1-weighted MRI (CE-T1WI) and DWI using b = 0, 200, 400, 600, 800 s/mm2. ADC maps were generated using subsets of b-values to investigate the effects of tissue ablation on water diffusion and perfusion in fibroids treated with MR-HIFU. Four combinations of b-values were used: (1) all b-values; (2) b = 0, 200 s/mm2; (3) b = 400, 600, 800 s/mm2; and (4) b = 0, 800 s/mm2.

Results

Using the lowest b-values (0 and 200 s/mm2), the mean ADC value in the ablated tissue reduced significantly (p < 0.001) compared with baseline. Calculating the ADC value with the highest b-values (400, 600, 800 s/mm2), the ADC increased significantly (p < 0.001) post-treatment. ADC maps calculated with the lowest b-values resulted in the best visual agreement of non-perfused fibroid tissue detected on CE images. Other b-value combinations and normal myometrium showed no difference in ADC after MR-HIFU treatment.

Conclusions

A decrease in contrast agent uptake within the ablated region on CE-T1WI was correlated to a significantly decreased ADC when b = 0 and 200 s/mm2 were used.

Key Points

• DWI could be useful for treatment evaluation after MR-HIFU of uterine fibroids
• The ADC in fibroid tissue is influenced by the choice of b- values
• Low b-values seem the best choice to emphasise perfusion effects after MR-HIFU
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Metadata
Title
Diffusion-weighted magnetic resonance imaging using different b-value combinations for the evaluation of treatment results after volumetric MR-guided high-intensity focused ultrasound ablation of uterine fibroids
Authors
Marlijne E. Ikink
Marianne J. Voogt
Maurice A. A. J. van den Bosch
Robbert J. Nijenhuis
Bilgin Keserci
Young-sun Kim
Koen L. Vincken
Lambertus W. Bartels
Publication date
01-09-2014
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 9/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-014-3274-y

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