# Quantitative Classification of Uterine Myoma Perfusion on DCE-MRI: Retrospective Analysis of Data and Clinical Implications

## TL;DR

This study uses MRI to classify uterine myoma perfusion, helping guide treatment choices for vascularization-targeted therapies.

## Contribution

A new quantitative classification of myoma vascularization based on DCE-MRI data is proposed.

## Key findings

- Three distinct perfusion groups were identified using KMeans clustering.
- Type III myomas were found exclusively in older patients.
- The classification could support automated assessment and clinical decision-making.

## Abstract

Background/Objectives: The degree of vascularization of myomas plays an important role in both diagnosis and the selection of appropriate treatment. This is particularly relevant for minimally invasive therapies such as uterine artery embolization (UAE), high-intensity focused ultrasound (HIFU), or radiofrequency ablation (RFA) in uterine myomas, as their effectiveness is highest in well-vascularized lesions. This study aimed to analyze the perfusion of uterine myomas using dynamic contrast-enhanced magnetic resonance imaging and to develop a new quantitative classification of lesion vascularization, referencing the Funaki classification. Methods: The study included 56 female patients. Three parameters were determined for each lesion: the maximum signal enhancement (Ratio), time to peak, and mean signal intensity (Mean). A KMeans cluster analysis (k = 3) was performed, dividing the data into three groups corresponding to Funaki types I–III. Results: Significant differences were observed between the groups. Type III myomas were found only in older patients, which may be relevant when qualifying patients for vascularization-targeted therapies such as HIFU or radiofrequency ablation. Conclusions: The proposed classification may serve as a basis for automating the assessment of myomas and supporting clinical decision-making.