Comparison of MRI outcomes of uterine artery embolization for uterine leiomyoma using tris-acryl gelatin microspheres, polyvinyl alcohol spheres, and polyvinyl alcohol particles

Objective: Comparison of recurrence of magnetic resonance imaging (MRI) enhancement of uterine fibroids treated with uterine artery embolization (UAE) among embolic agents: polyvinyl alcohol (PVA), spherical PVA (SPVA), and tris-acryl gelatin microspheres (GM). Methods: Pre/post-UAE gadolinium-enhanced MRIs were evaluated for residual enhancement of fibroids after UAE. Data were analyzed using 2-tail Fisher exact test to determine the likelihood of recurrence of enhancement post-UAE among embolic agents. Results: One hundred one women underwent UAE. A total of 24 (41%) of 59 embolized with PVA, 18 (75%) of 24 with SPVA, and 4 (22%) of 18 with GM showed residual enhancement in some or all fibroids. Statistically significant differences in presence of residual enhancement on follow-up were found between SPVA and PVA (P = 0.0072), and SPVA and GM (P = 0.0015), but not between PVA and GM (P = 0.1756). Conclusions: Patients embolized with SPVA have a higher risk of having residual enhancement on follow-up MRI than those embolized with PVA or GM.