I-51: Pioneering New Approaches to Reproductive Imaging

Background: Gynecologic conditions including uterine fibroids, adenomyosis and endometriosis lead to significant impairment in women’s’ lives and significant expen- Abstracts of the 12th Royan International Congress on Reproductive Biomedicine International Journal of Fertility & Sterility (IJFS), Vol 5, Suppl 1, Summer 2011 24 ditures of health care dollars. However, many women have symptoms long before a diagnosis is made. One of the goals of the Mayo Clinic Center for Uterine Fibroids and the Mayo Clinic Center for Study of Adenomyosis is to pioneer new diagnostic modalities to facilitate early diagnosis and individualized treatment. Our most advanced project is the use of magnetic resonance elastography (MRE) in characterizing uterine disease. Materials and Methods: MRE scans were performed on a 1.5 T whole-body imager with participants in the supine position and passive driver placed on their abdomen above the uterus. Continuous acoustic vibrations at 60 Hz were transmitted from an active driver to the passive driver through a flexible vinyl tube transmitting shear waves into the uterus. A modified 2-D gradient recalled echo (GRE) based elastography pulse sequence was used to collect wave images. The resulting 3 motion- sensitizing-gradient directional wave images were processed into a quantitative elastogram with units of kilopascal (kPa) using a previously described 2-D local frequency estimation (LFE) MRE inversion algorithm. Results: MRE is feasible to perform in a wide range of uterine sizes and subjects’ body mass index. There is considerable heterogeneity in uterine elasticity (2.08- 7.08 kPa) even among women with benign uterine disease. Conclusion: MRE is a promising technology for elucidating information about the heterogeneity of uterine disease. With further study, this technique may help characterize the ontogeny of uterine disease and provide noninvasive elucidation of genotype/phenotype interactions.