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Non-palpable contraceptive implants localization: review of imaging techniques and algorithm proposal.

Juan Carlos Soler-Perromat¹, Álvaro Bartolomé-Solanas¹, Montserrat Del Amo¹

¹Department of Radiology (CDI), Hospital Clinic of Barcelona, University of Barcelona (UB), Barcelona, Spain.

Quantitative Imaging in Medicine and Surgery

|November 15, 2024

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Contraceptive arm implants require imaging for removal if not palpable. Ultrasound is the primary method, followed by X-ray or MRI for difficult cases, ensuring safe and effective device retrieval.

Area of Science:

Radiology
Gynecology

Background:

Contraceptive arm implants offer long-acting birth control via subdermal rods.
Etonogestrel (ENG) and levonorgestrel (LNG) are common implant types.
Non-biodegradable implants necessitate removal after their licensed duration.

Purpose of the Study:

To review imaging techniques for locating non-palpable contraceptive arm implants.
To present a sequential algorithm for implant localization.

Main Methods:

Review of imaging modalities including Ultrasound (US), X-ray, Magnetic Resonance Imaging (MRI), and Computed Tomography (CT).
Description of a sequential approach integrating imaging based on implant characteristics and patient presentation.

Main Results:

Keywords:

Ultrasound (US)X-ray computed tomography (CT)contraceptive implant magnetic resonance imaging (MRI)

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Ultrasound is the first-line imaging modality for non-palpable implants.
X-ray and MRI are valuable for radiopaque, deep, or migrated implants.
CT is indicated for suspected pulmonary migration.

Conclusions:

A systematic approach to imaging is crucial for the safe and effective removal of non-palpable contraceptive implants.
The choice of imaging modality depends on implant characteristics and clinical presentation.