Live MR Angiographic Roadmapping for Uterine Artery Embolization: A Feasibility Study

Abstract

PurposeTo assess the feasibility of live magnetic resonance (MR) angiography roadmapping guidance for uterine artery (UA) embolization (UAE) for fibroid tumors. Materials and MethodsTwenty patients underwent UAE with live MR angiographic roadmapping. The pre-acquired MR angiography scan was coregistered with the live intraprocedural fluoroscopy stream to create a visual roadmap to direct the microcatheter during UAE. Patient radiation dose, as measured by dose–area product (DAP), procedure time, contrast medium volume, and fluoroscopy time, was recorded. For the first 10 patients, an additional parameter of contrast medium volume needed to catheterize each UA was recorded. ResultsIn all 20 patients (40 UAs), the MR angiography overlay on live fluoroscopy was accurate and allowed for successful catheterization of the UA, resulting in a technical success rate of 100%. In the subset of the initial 20 UAs (ie, the first 10 patients) in which this data point was recorded, 17 (85%) were successfully catheterized with no iodinated contrast medium at all, by purely relying on the MR angiography roadmap. Mean procedure time was 45 minutes (range, 30–99 min), mean contrast agent dose was 75 mL (range, 46–199 mL), and mean DAP was 155 Gy·cm2 (range, 37–501 Gy·cm2). ConclusionsLive MR angiographic roadmapping is feasible and accurate for catheter guidance during UAE.