Patient radiation exposure during uterine fibroid embolization and the dose attributable to aortography

The techniques used for uterine fibroid embolization (UFE) have rapidly evolved during the past decade. One source of uncertainty in the UFE technique has been the importance of the contribution of the ovarian artery to the blood supply of the uterus and fibroids. Although conventional aortography is often used after embolization to assess for collateral arterial supply, few patients are identified with sufficient collateral vessels to warrant supplemental embolization. One potential downside of routine aortography is the additional radiation dose. In this study, the radiation dose associated with UFE and the contribution of each component of the procedure to this dose were evaluated, with the specific goal of identifying the contribution from aortography. Although the overall radiation dose associated with UFE is moderate, aortography contributes a substantial amount of additional radiation, more than 20% of the total, which, coupled with its low clinical utility, suggests that the routine use of aortography at the conclusion of UFE should be reconsidered.