Growth of uterine leiomyomata among premenopausal black and white women.

Uterine leiomyomata (fibroids) are the leading cause of hysterectomy in the United States. Black women have a greater fibroid burden than whites, yet no study has systematically evaluated the growth of fibroids in blacks and whites. We prospectively tracked growth for 262 fibroids (size range: 1-13 cm in diameter) from 72 premenopausal participants (38 blacks and 34 whites). Fibroid volume was measured by computerized analysis of up to four MRI scans over 12 months. We used mixed effects models to identify factors that are associated with growth, and results were converted to percent change per 6 months for clinical relevance. The median growth rate was 9% (range: -89% to +138%). Seven percent of fibroids regressed (>20% shrinkage). Tumors from the same woman grew at different rates (within-woman component of variation was twice the component among women; both were significant, P < 0.001). Black and white women less than 35 years of age had similar fibroid growth rates. However, growth rates declined with age for whites but not for blacks (P = 0.05). The odds of a tumor growing more than 20% in 6 months also decreased with age for whites but not for blacks (P < 0.01). Growth rates were not influenced by tumor size, location, body mass index, or parity. We conclude that (i) spontaneous regression of fibroids occurs; (ii) fibroids from the same woman grow at different rates, despite a uniform hormonal milieu; (iii) fibroid size does not predict growth rate; and (iv) age-related differences in fibroid growth between blacks and whites may contribute to the higher symptom burden for black women.

Accurate quantification of visceral adipose tissue (VAT) using water-saturation MRI and computer segmentation: preliminary results.

PURPOSE: To describe and evaluate the accuracy of water-saturation MRI and a computer segmentation program for quantification of visceral adipose tissue (VAT). MATERIALS AND METHODS: MRI was performed on five patients with whole-volume coverage of the abdomen using two different sequences: 1) a T1-weighted spoiled gradient-echo breath-hold sequence (non-water-saturation) and 2) a T1-weighted spoiled gradient-echo water-saturation breath-hold sequence (water-saturation). The computer segmentation program analyzed the data and calculated VAT volumes (cm3) from both sequences. The data from one patient were additionally processed with the use of a manual technique. The intrastudy reproducibility of the proposed method using the water-saturation MRI sequence and the computer segmentation technique was tested by repeated measures of the automated system analysis (x 10) on MRI data from a single subject to calculate variability. RESULTS: VAT volumes measured by the water-saturation MRI sequences were consistently greater than those measured by the non-water-saturation sequences. Comparison of VAT volumes derived from the water-saturation images and measured by the computer segmentation technique vs. the manual technique showed good correlation (K = 0.8), with a significant time-saving benefit associated with the automated method (5 minutes vs. 1 hour). There was poor correlation between VAT volume measurement calculated by the manual technique and the computer segmentation technique using non-water-saturation images. The reproducibility of the computer segmentation technique using data derived from water-saturation images was high, with a low variability (+/- 5%). CONCLUSION: The results obtained demonstrate that the proposed method may be able to provide accurate quantification of VAT in a highly reproducible and efficient manner.