ArticleAbdominal radiology (New York)2026
Pretreatment MRI parameters as predictive biomarkers for short-term clinical response to dienogest in adenomyosis: a retrospective cohort study.
Article in Abdominal radiology (New York), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo evaluate whether pretreatment magnetic resonance imaging (MRI) parameters can predict short-term clinical response to dienogest (DNG) in patients with adenomyosis.
methodsThis retrospective study included 78 patients with MRI-diagnosed adenomyosis who underwent pelvic MRI before hormonal therapy between October 2018 and July 2025. Quantitative MRI parameters included T2 signal intensity ratios, diffusion-weighted imaging (DWI) signal intensity ratios, normalized apparent diffusion coefficient (ADC), and uterine morphological parameters. Adenomyosis subtypes were classified according to the modified Kishi criteria. Short-term clinical response was assessed primarily 3-6 months after treatment initiation as a composite clinical outcome encompassing symptom improvement (dysmenorrhea, menstrual blood loss, and/or hemoglobin levels) and treatment continuation; patients were classified as responders or non-responders. Predictive analyses were restricted to the DNG cohort because only one patient in the GnRH cohort was a non-responder.
resultsOf the 78 patients, 32 received gonadotropin-releasing hormone (GnRH) agonist or antagonist therapy and 46 received DNG. In the DNG cohort, 30 patients were responders and 16 were non-responders. MRI-based adenomyosis subtype, lesion distribution, and uterine morphological parameters were not significantly associated with response in DNG-treated patients. However, absolute ADC values were significantly higher in responders (1.03 vs. 0.89 × 10⁻
conclusionQuantitative diffusion MRI parameters were associated with short-term clinical response to DNG, whereas conventional morphological features were not. Diffusion-weighted MRI may provide complementary imaging biomarkers for adenomyosis stratification in DNG-treated patients; prospective validation with longer follow-up is warranted.
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