European Radiology

, Volume 27, Issue 12, pp 5299–5308 | Cite as

The role of T1 perfusion-based classification in magnetic resonance-guided high-intensity focused ultrasound ablation of uterine fibroids

Magnetic Resonance

Abstract

Objective

To comparatively evaluate the role of magnetic resonance (MR) T1 perfusion-based time–signal intensity (SI) curves of fibroid tissue and the myometrium in classification of fibroids for predicting treatment outcomes of high-intensity focused ultrasound (HIFU) treatment.

Methods

The fibroids of 74 women who underwent MR-HIFU treatment were classified into group A (time–SI curve of fibroid lower than that of the myometrium) and group B (time–SI curve of fibroid equal to or higher than that of the myometrium). Non-perfused volume (NPV) ratios immediately after treatment and fibroid volume reduction ratios and symptom severity scores (SSS) at the 6-month follow-up were retrospectively assessed.

Results

The immediate NPV ratios in groups A and B were 95.3 ± 6.3% (n = 62) and 63.8 ± 11% (n = 12), respectively. At the 6-month follow-up, the fibroid volume reduction ratios in groups A and B were 0.52 ± 0.14 (n = 50) and 0.07 ± 0.14 (n = 11), with the corresponding improvement in mean transformed SSS being 0.86 ± 0.14 and 0.19 ± 0.3, respectively. No serious adverse effects were reported.

Conclusions

Our novel classification method could play an important role in classifying fibroids for predicting the immediate outcomes of HIFU treatment.

Key Points

MRI is an important modality for outcome prediction in HIFU treatment

Patient selection is a significant factor for achieving high NPV ratio

NPV ratio is very strongly correlated with T1 perfusion-based classification

T1 perfusion-based classification is a strong predictor of treatment outcome

Keywords

Uterine fibroids Myometrium T1 perfusion Magnetic resonance imaging High-intensity focused ultrasound Therapeutic outcome 

Abbreviations

AE

adverse effect

CE-T1W

contrast-enhanced T1 weighted

DCE-MRI

dynamic contrast-enhanced magnetic resonance imaging

EPI

eco-planar imaging

HIFU

high-intensity focused ultrasound

MR-HIFU

magnetic resonance-guided high-intensity focused ultrasound

MRI

magnetic resonance imaging

NPV

non-perfused volume

ROI

region of interest

SSS

symptom severity score

T2W-TSE

T2-weighted turbo spin-echo

Notes

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Dr. Nguyen Minh Duc, Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam.

Conflict of interest

The authors of this manuscript declare a relationship with the following company: Bilgin Keserci is an employee of Philips.

Funding

The authors state that this work has not received any funding.

Statistics and biometry

Both authors have significant statistical expertise.

Ethical approval

Institutional review board approval was obtained.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Methodology

• prospective

• cross-sectional study

• performed at one institution

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Copyright information

© European Society of Radiology 2017

Authors and Affiliations

  1. 1.MR Therapy Division, PhilipsJung-guSouth Korea
  2. 2.Department of RadiologyPham Ngoc Thach University of MedicineHo Chi Minh CityVietnam

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