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Purpose: Apparent diffusion coefficient (ADC) values, which are derived from diffusion-weighted imaging, have a potential role for predicting treatment response. A systematic review was conducted to examine the value of baseline ADC values for predicting leiomyoma size reduction after uterine arterial embolization (UAE).Methods: Study selection, quality appraisal and data extraction were conducted independently by two authors. Statistical analyses included the calculation of weighted means and summary correlation coefficients (under the random effects model).Results: Eleven studies consisting of a total of 258 patients (age, weighted mean±standard deviation [SD], 43.1±10.1 years) were included. The weighted mean±SD ADC value was 1.2±1.5 ×10-3 s/mm2 at baseline (ten studies) and 1.3±2.8 ×10-3 s/mm2 at approximately 6 months after embolization (six studies). The weighted mean percentage leiomyoma volume reduction (VR) at 6 months was 47.1%±35.6% (seven studies). Based on four studies, the weighted summary correlation coefficient for the correlation between baseline ADC and leiomyoma VR at approximately 6 months was not significant (r=0.40; 95% CI, -0.07 to 0.72; I2=69.7%). No associations were found in three of the four studies that examined changes in ADC values as a predictor.Conclusion: Due to high heterogeneity, it is unclear whether ADC may be useful for predicting treatment responses to UAE. [ABSTRACT FROM AUTHOR]