Researchers at Northwestern University Feinberg School of Medicine are recommending uterine fibroids for proper treatment. The lead author of the study, Dr. Paul Nikolaidis, presented their findings at the annual conference of the American Roentgen Ray Society on May 3. The study showed that an MRI exam often ruled out uterine fibroid embolization (UFE) as an appropriate treatment.
UFE is a common and effective non-surgical treatment for uterine fibroids. In this procedure, small pieces of PVA plastic, the size of grains of sand, are inserted through a catheter into the uterine artery, where they block the flow of blood to the fibroids. This can cause the fibroids to shrink. UFE has become an increasingly common treatment, even in cases in which it may be less effective. These cases include "patients with a single nonliving fibroid or patients with significant coexisting disease," according to Nikolaidis.
The researchers studied 100 women who had been diagnosed with fibroids and referred for UFE. After assessing the patients with MRI, the researchers recommended against UFE for more than one-fifth of the women.
Nikolaidis stated that one of the researchers’ goals was "to help radiologists and gynecologists use a unified approach in the evaluation and management of uterine fibroids." Currently there are three main methods for evaluating uterine fibroids for appropriate treatment: a pelvic exam, an ultrasound procedure, and an MRI. A pelvic exam can only detect larger fibroids, present in about 30% of women. Ultrasound imaging can help doctors identify the fibroids, but Nikolaidis credits the MRI with better visualization of the tumors, including higher contrast and spatial resolution. Smaller fibroids can be detected in more than 75% of women using the highly sensitive MRI technique.
MRI procedures are expensive and may not be available in all places, and many insurance companies may not want to pay for the procedure if other, less expensive options are available.
Uterine fibroids are a common benign (noncancerous) tumor of the female pelvis, attached to the wall of the uterus. More than 20%, and perhaps as many as 75%, of women are likely to have uterine fibroids. They can range in size from microscopic to several inches in diameter and may weigh several pounds. Common side effects can include constipation, back pain, and abdominal swelling, though most women never experience symptoms from their fibroids or require treatment.