ParticipantsBilgin Keserci, PhD, Kota Bharu, Malaysia (Abstract Co-Author) Nothing to Disclose
Nguyen Minh Duc, MD, Ho Chi Minh, Vietnam (Presenter) Nothing to Disclose
bushido.keserci@gmail.com
PURPOSETo investigate the role of semiquantitative T1 perfusion parameters in predicting the uterine fibroid treatment outcome of magnetic resonance-guided high-intensity focused ultrasound (MRgHIFU) ablation with an immediate nonperfused volume (NPV) ratio of at least 80%.
METHOD AND MATERIALSThis study protocol was designed as a prospective study. 90 women (mean age, 39.9±5.5 years with a range of 22-53 years) underwent volumetric MRgHIFU ablation during a period of 15 months beginning June 2015 were divided into two groups: group 1 (n = 56, NPV ratio of at least 80%) and group 2 (n = 34, NPV ratio less than 80%). The software automatically generated time-SI curves and then calculated the semiquantitative perfusion parameters of each region of interest of uterine fibroids on perfusion axial MR imaging data. The receiver operating characteristic (ROC) curve was further analyzed to determine the area under the curve (AUC) of each semiquantitative parameter.
RESULTSThe mean NPV ratio for groups I and II was 96.1% ±5.8 (80-100 %) and 50.7% ±26.9 (4.3-79.7%), respectively. The semiquantitative perfusion parameters were significantly different in both groups. The ROC curve analyses revealed that the AUC for relative enhancement, maximum enhancement, maximum relative enhancement, time to peak, wash-in rate and the area under the time-signal intensity curve of uterine fibroids for predicting the immediate NPV ratio of at least 80% was 0.746, 0.851, 0.777, 0.204, 0.911 and 0.720, respectively.
CONCLUSIONOur findings revealed that semi-quantitative perfusion parameters were effective factors in predicting the NPV ratio of at least 80%. Wash-in rate parameter was the highest AUC in predicting the treatment success defined as NPV ratio of at least 80%.
CLINICAL RELEVANCE/APPLICATIONMRgHIFU ablation for uterine fibroids is a noninvasive therapeutic treatment to preserve the uterus. The achievement of NPV ratio of at least 80% in HIFU treatment of uterine fibroids based on significant semi-quantitative perfusion parameters as a measure of technical success appears to be clinically possible without sacrificing the safety.