Predictive value of contrast-enhanced MRI for the regrowth of residual uterine fibroids after high-intensity focused ultrasound treatment.

IF 4.1 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Insights into Imaging Pub Date : 2024-11-15 DOI:10.1186/s13244-024-01839-w

Yang Liu, Zhibo Xiao, Yuanli Luo, Xueke Qiu, Lu Wang, Jinghe Deng, Mengchu Yang, Fajin Lv

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Abstract

Objectives: To investigate whether the signal intensity (SI) ratio of residual fibroid (RF) to myometrium using Contrast-Enhanced Magnetic Resonance Imaging (CE-MRI) could predict fibroid regrowth after high-intensity focused ultrasound (HIFU) treatment.

Materials and methods: A retrospective analysis was conducted among 164 patients with uterine fibroids who underwent HIFU. To predict the RF regrowth, the SI perfusion parameters were quantified using the RF-myometrium SI ratio on CE-MRI on day 1 post-HIFU and then compared with the fibroid-myometrium SI ratio on the T2-weighted image (T2WI) and Funaki classification 1 year later. Thirty cases from another center were used as an external validation set to evaluate the performance of RF-myometrium SI ratio.

Results: The predictive performance of the RF-myometrium SI ratio on CE-MRI on day 1 post-HIFU (Area Under Curve, AUC: 0.869) was superior to that of the preoperative and postoperative fibroid-myometrium SI ratios on the T2WI (AUC: 0.724, 0.696) and Funaki classification (AUC: 0.663, 0.623). Multivariate analysis showed that the RF- myometrium SI ratio and RF thickness were independent factors. The RF-myometrium SI ratio reflects the long-term rate of re-intervention (r = 0.455, p < 0.001).

Conclusion: The RF-myometrium SI ratio on CE-MRI exhibits greater accuracy in predicting RF regrowth compared to the SI classification and the SI ratio on T2WI.

Critical relevance statement: The ratio of residual uterine fibroid to myometrial signal intensity on contrast-enhanced (CE)-MRI can reflect residual blood supply, predict regrowth of fibroids, and thus reflect long-term re-intervention rate and recovery situation of clinical high-intensity focused ultrasound (HIFU) treatment.

Key points: Contrast-enhanced (CE)-MRI can indicate the blood supply of residual uterine fibroids after high-intensity focused ultrasound (HIFU) treatment. The predictive capability of CE-MRI ratio surpasses T2WI ratio and the Funaki. Residual fibroids can serve as a measure of the long-term efficacy of HIFU.

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对比增强磁共振成像对高强度聚焦超声治疗后残留子宫肌瘤再生的预测价值。

研究目的研究对比增强磁共振成像（Contrast-Enhanced Magnetic Resonance Imaging，CE-MRI）显示的残留肌瘤（RF）与子宫肌层的信号强度（SI）比值能否预测高强度聚焦超声（HIFU）治疗后肌瘤的再生情况：对164名接受HIFU治疗的子宫肌瘤患者进行了回顾性分析。为了预测射频再生长情况，在HIFU术后第1天使用CE-MRI上的射频-子宫肌层SI比值对SI灌注参数进行量化，然后与T2加权成像（T2WI）上的肌瘤-子宫肌层SI比值以及1年后的Funaki分类进行比较。另一个中心的30个病例作为外部验证集，以评估射频-子宫肌瘤SI比值的性能：结果：HIFU术后第1天CE-MRI上的射频-子宫肌瘤SI比值的预测性能（曲线下面积，AUC：0.869）优于T2WI上的术前和术后肌瘤-子宫肌瘤SI比值（AUC：0.724，0.696）和Funaki分类（AUC：0.663，0.623）。多变量分析表明，射频-子宫肌层 SI 比值和射频厚度是独立因素。射频-子宫肌层 SI 比值反映了长期的再介入率（r = 0.455，p 结论：射频-子宫肌层 SI 比值和射频厚度是独立因素：与SI分类和T2WI上的SI比值相比，CE-MRI上的射频-子宫肌层SI比值在预测射频再生长方面表现出更高的准确性：对比增强（CE）-MRI上残留子宫肌瘤与子宫肌层信号强度的比值可反映残留血供，预测肌瘤再生，从而反映临床高强度聚焦超声（HIFU）治疗的长期再介入率和恢复情况：对比增强（CE）-MRI可显示高强度聚焦超声（HIFU）治疗后残留子宫肌瘤的血供情况。CE-MRI 比值的预测能力超过了 T2WI 比值和 Funaki。残留肌瘤可作为衡量 HIFU 长期疗效的指标。

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来源期刊

Insights into Imaging Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

7.30

自引率

4.30%

发文量

182

审稿时长

13 weeks

期刊介绍： Insights into Imaging (I³) is a peer-reviewed open access journal published under the brand SpringerOpen. All content published in the journal is freely available online to anyone, anywhere! I³ continuously updates scientific knowledge and progress in best-practice standards in radiology through the publication of original articles and state-of-the-art reviews and opinions, along with recommendations and statements from the leading radiological societies in Europe. Founded by the European Society of Radiology (ESR), I³ creates a platform for educational material, guidelines and recommendations, and a forum for topics of controversy. A balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes I³ an indispensable source for current information in this field. I³ is owned by the ESR, however authors retain copyright to their article according to the Creative Commons Attribution License (see Copyright and License Agreement). All articles can be read, redistributed and reused for free, as long as the author of the original work is cited properly. The open access fees (article-processing charges) for this journal are kindly sponsored by ESR for all Members. The journal went open access in 2012, which means that all articles published since then are freely available online.