Optimizing the Angiography Protocol to Reduce Radiation Dose in Uterine Artery Embolization: The Impact of Digital Subtraction Angiographies on Radiation Exposure

Purpose: Current knowledge concerning the use of uterine artery embolization (UAE) in large uterine fibroids is limited with the majority of studies being limited to case reports. The present retrospective study aimed to investigate the impact of UAE on symptoms and tumor size in symptomatic women with at least one large uterine fibroid. Methods: 39 patients undergoing UAE for symptomatic large uterine fibroids (>5cm) were consecutively enrolled in this study. All patients underwent a detailed physical examination and contrast-enhanced pelvic MRI at 3, 6 and 12 months after the procedure. Results: Compared to baseline values (7.8 ± 2.4 cm), the mean diameter of the fibroids significantly reduced at 3rd (5.5 ± 1.7 cm), 6th (4.2 ± 1.3 cm) and 12th (3.1 ± 0.6 cm) months follow-up (p<0.005 for each compared to baseline) implying a 60 % reduction in tumor size at 12 months compared to baseline measurements. At the end of the 12 months follow-up, complete necrosis of the fibroid was achieved in 88%, complete symptom resolution was achieved in 92%, and >50 % reduction in fibroid diameter was acquired in 87 % of the participants. Conclusion: Uterine artery embolization provides 60 % reduction in fibroid volume and a 92 % improvement in fibroid-related symptoms in patients with large fibroids at the end of 12 months follow-up.

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Evaluation of scattered radiation dose received by medical staff during uterine artery embolization in the operating room

Technology and Health Care ◽

10.3233/thc-209002 ◽

2020 ◽

Vol 28 ◽

pp. 3-11

Author(s):

Hsien-Wen Chiang ◽

Hsien-Jen Chiang ◽

Jung-Hui Li ◽

Leo Leung-Chit Tsang

Keyword(s):

Radiation Dose ◽

Operating Room ◽

Scattered Radiation ◽

Medical Staff ◽

Uterine Artery Embolization ◽

Uterine Artery ◽

Artery Embolization

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Analysis of Factors Affecting Air Kerma Area Product Obtained during Uterine Artery Embolization Procedures Using Logistic Regression

Indian Journal of Radiology and Imaging ◽

10.1055/s-0041-1733814 ◽

2021 ◽

Author(s):

Khaled Soliman ◽

Ahmed Almutairi ◽

Murdhi AlHarbi ◽

Khaleel Almutairi ◽

Turky Almutairi ◽

...

Keyword(s):

Logistic Regression ◽

Radiation Dose ◽

Uterine Artery Embolization ◽

Uterine Artery ◽

Area Under The Curve ◽

Multivariable Logistic Regression Analysis ◽

Artery Embolization ◽

Factors Affecting ◽

Area Product ◽

To Receive

Abstract Purpose Uterine artery embolization (UAE) is a common interventional radiology procedure used in medicine; the procedure is safe but there is always a concern regarding radiation dose received by the patient. The aim of this study was to use multivariable logistic regression analysis (MLRA) to study a certain number of independent prognostic variables believed to provide an estimate of the likelihood of obtaining a high kerma area product (P KA) at the end of the procedure. Method Radiation dose indices registered by the angiographic system structured dose report, the total fluoroscopy time (FT), the patient’ body mass index (BMI), the number of images taken during the procedures (IMGS), and the performing physician experience (EXPER) were used to drive a logistic regression model (LRM). Results The LRM found was: Logit (P KA) = −6.1525 + 0.0416 (FT) + 0.1028 (IMGS) + 0.1675 (BMI) – 0.1012 (EXPER). The prediction accuracy of the LRM was assessed using receiver operating characteristic (ROC) curve; by calculating the area under the curve (AUC), we found AUC = 0.7896, with optimal ROC point of 0.3261, 0.8036. Conclusion The suggested LRM seems to indicate that patients with higher BMI, have taken longer FT, acquired higher IMGS and the procedure done by a less experienced performing physician is more susceptible to receive a higher P KA at the end. The proposed LRM is useful in predicting the occurrence of higher radiation exposure interventions and can be used in patients’ radiation dose optimization strategies during UAE procedures.

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