A novel scoring system based on magnetic resonance imaging for the prediction of the difficulty of ultrasound-guided high-intensity focused ultrasound ablation for uterine fibroids.

IF 3 3区 医学 Q2 ONCOLOGY International Journal of Hyperthermia Pub Date : 2024-01-01 Epub Date: 2024-08-04 DOI:10.1080/02656736.2024.2386098
Ying Zhang, Qian Wang, Yangyang Wang, Rong Ma, Min He, Lian Zhang
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Abstract

Objective: To develop a novel scoring system based on magnetic resonance imaging (MRI) for predicting the difficulty of ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation for uterine fibroids.

Materials and methods: A total of 637 patients with uterine fibroids were enrolled. Sonication time, non-perfused volume ratio (NPVR), and ultrasound energy delivered for ablating 1 mm3 of fibroid tissue volume (E/V) were each classified as three levels and assigned scores from 0 to 2, respectively. Treatment difficulty level was then assessed by adding up the scores of sonication time, NPVR and E/V for each patient. The patients with score lower than 3 were categorized into low difficulty group, with score equal to or greater than 3 were categorized into high difficulty group. The potential predictors for treatment difficulty were compared between the two groups. Multifactorial logistic regression analysis model was created by analyzing the variables. The difficulty score system was developed using the beta coefficients of the logistic model.

Results: Signal intensity on T2WI, fibroid location index, largest diameter of fibroids, abdominal wall thickness, homogeneity of the signal of fibroids, and uterine position were independent influencing factors for the difficulty of USgHIFU for uterine fibroids. A prediction equation was obtained: difficulty score = 17 × uterine position (anteverted =0, retroverted =1)+71 × signal intensity (hypointense = 0, isointense/hyperintense = 1) +8 × enhancement (homogenous = 0, heterogeneous = 1)+25×(largest diameter of fibroids-20) +35 × (fibroid location index -0.2) +1×(abdominal wall thickness -5).

Conclusions: This scoring system established based on MRI findings can be used to reliably predict the difficulty level of USgHIFU treatment of uterine fibroids.

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基于磁共振成像的新型评分系统,用于预测超声引导下高强度聚焦超声消融治疗子宫肌瘤的难度。
目的:开发一种基于磁共振成像(MRI)的新型评分系统,用于预测超声引导下高强度聚焦超声(USgHIFU)消融治疗子宫肌瘤的难度:共纳入 637 例子宫肌瘤患者。声波治疗时间、非灌注容积比(NPVR)和消融 1 mm3 子宫肌瘤组织容积所需的超声能量(E/V)被分为三个等级,并分别从 0 到 2 之间打分。然后将每位患者的超声时间、NPVR 和 E/V 分数相加,评估治疗难度。得分低于 3 分的患者被归为低难度组,得分等于或大于 3 分的患者被归为高难度组。比较两组患者治疗难度的潜在预测因素。通过分析这些变量,建立了多因素逻辑回归分析模型。利用逻辑模型的贝塔系数建立了难度评分系统:结果:T2WI信号强度、肌瘤位置指数、肌瘤最大直径、腹壁厚度、肌瘤信号均匀性和子宫位置是USgHIFU治疗子宫肌瘤难度的独立影响因素。得出的预测方程为:难度评分=17×子宫位置(前倾=0,后倾=1)+71×信号强度(低密度=0,等密度/高密度=1)+8×增强(同质=0,异质=1)+25×(肌瘤最大直径-20)+35×(肌瘤位置指数-0.2)+1×(腹壁厚度-5):根据核磁共振成像结果建立的这一评分系统可用于可靠地预测 USgHIFU 治疗子宫肌瘤的难度。
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来源期刊
CiteScore
5.90
自引率
12.90%
发文量
153
审稿时长
6-12 weeks
期刊介绍: The International Journal of Hyperthermia
期刊最新文献
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