Uterine Artery Embolization: Optimization with Preprocedural Prediction of the Best Tube Angle Obliquity by Using 3D-Reconstructed Contrast-enhanced MR Angiography

Abstract

To evaluate the effect of preprocedural prediction of the best tube angle obliquity for visualization of the uterine artery origin by using three-dimensional (3D)-reconstructed contrast material-enhanced magnetic resonance (MR) angiography on the radiation dose, fluoroscopy time, and contrast medium volume during uterine artery embolization (UAE). The study was approved by the institutional review board. Informed consent was obtained. The prospective study included 20 consecutive prospective patients (age range, 37-56 years) for whom preprocedural prediction of the best tube angle obliquity was determined by using 3D-reconstructed contrast-enhanced MR angiography; the best tube angle obliquity was provided to the interventionist. Three-dimensional reconstruction was performed by using an application of the angiographic unit. The radiation dose, fluoroscopy time, and contrast medium volume for those patients were compared with those data in 20 retrospectively assessed control patients (age range, 39-56 years) from the prior 20 procedures performed by the same interventionist. Tube angle prediction resulted in a significant reduction in the radiation dose utilized (P < .001), fluoroscopy time (P = .002), and contrast medium volume (P < .001) for the sample patients compared with those for the control patients. Overall radiation dose was reduced from a mean of 11 044 microGy per square meter to a mean of 4172.5 microGy per square meter. Fluoroscopy time was reduced from a mean of 15 minutes 30 seconds to 8 minutes 49 seconds. Contrast medium volume was reduced from a mean of 135 mL to 75 mL. Preprocedural prediction of the best tube angle obliquity for visualization of the origin of the uterine artery by using 3D-reconstructed contrast-enhanced MR angiography results in significant reductions in radiation dose, fluoroscopy time, and contrast medium volume during UAE.