# Evaluation of Uterine Fibroids by Contrast Enhanced Ultrasound (CEUS) and Subharmonic-Aided Pressure Estimation (SHAPE) Pre and Post Uterine Artery Embolization (UAE)

> **NIH NIH R21** · THOMAS JEFFERSON UNIVERSITY · 2024 · $195,000

## Abstract

Uterine fibroids affect approximately 30% of all women in the United States or about 45 million
individuals. The clinical diagnosis of uterine fibroids is two to three times more common in African-
American women than in Caucasian women. Uterine artery embolization (UAE) is a nonsurgical
therapy that shrinks fibroids by blocking arterial blood flow to the lesions. Prior to the UAE
procedure almost all patients receive a contrast-enhanced MRI, which is currently considered the
reference imaging method. After the UAE, the current strategy is to request a contrast-enhanced
MRI to evaluate the efficacy of the treatment. However, an MRI is not always available and
remains very expensive. Ultrasound imaging offers a low cost, non-invasive, and readily available
approach, which can characterize both structural and functional features of tumor vascularity from
its earliest stages. Moreover, microbubble-based ultrasound contrast agents (UCA) not only
enhance the backscattered signals, but at higher acoustic pressures they also act as nonlinear
oscillators producing significant energy components in the received echo signals. These nonlinear
bubble echoes can be separated from tissue echoes and used to create contrast specific
ultrasound imaging modalities (e.g., harmonic imaging; HI). HI preferentially enhances and
displays contrast signals rather than surrounding tissue echoes by transmitting at the fundamental
transducer frequency (f0) and receiving at the second harmonic (2f0). HI is commercially available
on most state-of-the-art ultrasound scanners. Our group developed the fundamental concept of
contrast-enhanced subharmonic-aided pressure estimation (SHAPE). This approach relies on
using the inverse linear relationship between subharmonic signals from UCA and the ambient
pressures. Therefore, we believe that development of SHAPE as an accurate noninvasive
technique for measurement of ambient pressure can be translated for the evaluation of uterine
fibroids pressures in order to establish parameters for dynamic evaluation. Thus, this study goals
are to determine the patterns of uterine fibroid vascularity pre and post UAE using CEUS resulting
in an alternative to gadolinium-enhanced MRI that is less expensive, has less contra-indications
and side effects, is real time, and noninvasive helping physicians to evaluate the result of UAE
procedures. Also, this study will evaluate uterine fibroid pressures using SHAPE, comparing the
results with normal myometrium tissue in order to determine its characteristics and tissue
differences, which we believe will lead to the development of a new biomarker for the diagnosis
and treatment of uterine fibroids.

## Key facts

- **NIH application ID:** 10951023
- **Project number:** 1R21HD116236-01
- **Recipient organization:** THOMAS JEFFERSON UNIVERSITY
- **Principal Investigator:** Carin F Gonsalves
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $195,000
- **Award type:** 1
- **Project period:** 2024-08-01 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10951023

## Citation

> US National Institutes of Health, RePORTER application 10951023, Evaluation of Uterine Fibroids by Contrast Enhanced Ultrasound (CEUS) and Subharmonic-Aided Pressure Estimation (SHAPE) Pre and Post Uterine Artery Embolization (UAE) (1R21HD116236-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10951023. Licensed CC0.

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