Diagnosis of gynecologic malignancy after the treatment of presumed benign fibroid disease with interventional radiology procedures: a retrospective cohort study.

OBJECTIVE: To ascertain the finding of future diagnosis of malignancy in women who undergo nonsurgical treatment for uterine fibroid disease with interventional radiology (IR) procedures. DESIGN: Mixed-methods retrospective cohort study. SETTING: Two tertiary care academic hospitals in Boston, Massachusetts. PATIENT(S): A total of 491 women who underwent radiologic intervention for fibroids between 2006 and 2016. INTERVENTION(S): Uterine artery embolization or high-intensity focused ultrasound ablation. MAIN OUTCOME MEASURE(S): Subsequent surgical interventions and diagnosis of gynecologic malignancy after the IR procedure. RESULT(S): During the study period, 491 women underwent treatment of fibroids with IR procedures; follow-up information was available for 346 cases. The mean age was 45.3 ± 4.8 years, and 69.7% were between the ages of 40 and 49 years. Regarding ethnicity, 58.9% of patients were white, and 26.1% were black. The most common symptoms were abnormal uterine bleeding (87%), pelvic pressure (62.3%), and pelvic pain (60.9%). A total of 106 patients underwent subsequent surgical treatment of fibroids. Of the 346 patients who had follow-up, 4 (1.2%) were diagnosed with leiomyosarcoma after their interventional treatment for fibroids. An additional 2 cases of endometrial adenocarcinoma and 1 case of a premalignant lesion of the endometrium were noted. CONCLUSION(S): The proportion of patients who went on to be diagnosed with leiomyosarcoma after conservative IR treatments appears to be higher than previously reported. A thorough preprocedural workup and patient counseling regarding the possibility of underlying uterine malignancy should be undertaken.

Residual magnetism in an MRI suite after field-rampdown: what are the issues and experiences?

PURPOSE: To investigate residual magnetization at different locations in the MRI suite at several time points prior, during and after field-rampdown with the goal to determine if the MRI suites could be reused in a clinical environment after the field-rampdown of MR scanners of different field strengths. MATERIALS AND METHODS: Residual magnetism was measured with two gaussmeters in the MRI suites of an 8 Tesla (T) and a 0.7T whole body magnet at several time points prior, during and after field-rampdown. RESULTS: Residual magnetism, in the MRI suite after controlled rampdown of an 8T superconducting magnet, was not significantly elevated compared with magnetic fields in the environment. Through 40 days, no significant changes in magnetism could be seen compared with initial measurements directly after rampdown, as both gaussmeters consistently measured. Similar findings were also observed after the quenched shutdown of a 0.7T system but a remanence was observed. CONCLUSION: A controlled rampdown of even an ultrahigh field MR system does not lead to retained magnetic contamination, while forced quenched rampdown of a mid-field system revealed temporary remanence. There is no need to degauss an MRI suite when an appropriate steel composition has been used in the iron shield.

Clinical magnetic resonance imaging of brain tumors at ultrahigh field: a state-of-the-art review.

With the advancement of the magnetic resonance (MR) technology, the whole-body ultrahigh field MR system operated from 7 to 9.4 T becomes feasible for the routine patient imaging in clinical settings. The associated potentials and challenges from the perspectives of technology, physics, and biology as well as clinical application of the ultrahigh field MR systems are different from those systems operated at 3 T, 1.5 T, or lower field strength. In this article, we will present our initial experiences of brain tumor imaging using the 7 and 8 T whole-body MR systems at the Ohio State University Medical Center and provide a brief overview pertinent to the ultrahigh field clinical MR systems.