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Predicting the efficacy of high-intensity focused ultrasound (HIFU) ablation for uterine leiomyomas based on DTI indicators and imaging features

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Abstract

Purpose

To predict the efficacy of high-intensity focused ultrasound (HIFU) ablation for uterine leiomyomas based on diffusion tensor imaging (DTI) indicators and imaging features.

Methods

Sixty-two patients with 85 uterine leiomyomas were consecutively enrolled in this retrospective study and underwent DTI scanning before HIFU treatment. Based on whether the non-perfused volume ratio (NPVR) was greater than 70%, all patients were assigned to sufficient ablation (NPVR ≥ 70%) or insufficient ablation (NPVR < 70%) groups. The selected DTI indicators and imaging features were incorporated to construct a combined model. The predictive performance of DTI indicators and the combined model were assessed using receiver operating characteristic (ROC) curves.

Results

There were 42 leiomyomas in the sufficient ablation group (NPVR ≥ 70%) and 43 leiomyomas in the insufficient ablation group (NPVR < 70%). The fractional anisotropy (FA) and relative anisotropy (RA) values were higher in the sufficient ablation group than in the insufficient ablation group (p < 0.05). Conversely, the volume ratio (VR) and mean diffusivity (MD) values were lower in the sufficient ablation group than those in the insufficient ablation group (p < 0.05). Notably, the combined model composed of the RA and enhancement degree values had high predictive efficiency, with an AUC of 0.915. The combined model demonstrated higher predictive performance than FA and MD alone (p = 0.032 and p < 0.001, respectively) but showed no significant improvement compared with RA and VR (p > 0.05).

Conclusion

DTI indicators, especially the combined model incorporating DTI indicators and imaging features, can be a promising imaging tool to assist clinicians in predicting HIFU efficacy for uterine leiomyomas.

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Data availability

The data used to support the findings of this study are available from the corresponding author upon request.

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Funding

This study has received funding from Nanchong City School Cooperation Project (No.19SXHZ0429).

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Author notes

  1. Shi-ze Qin and Yu Jiang have contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Affiliated Hospital of North Sichuan Medical College, No. 1, Maoyuan South Road, Shunqing District, Nanchong, 637000, China

    Shi-ze Qin, Yu Jiang, Nian Liu, Zhen-yang Lin, Qing Jia, Jie Fang & Xiao-hua Huang

  2. School of Clinical Medicine, North Sichuan Medical College, No. 234, Fujiang Road, Shunqing District, Nanchong, 637000, China

    Yan-lin Wang

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Qin, Sz., Jiang, Y., Wang, Yl. et al. Predicting the efficacy of high-intensity focused ultrasound (HIFU) ablation for uterine leiomyomas based on DTI indicators and imaging features. Abdom Radiol (2023). https://doi.org/10.1007/s00261-023-03865-6

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