ParticipantsNguyen Minh Duc, MD, Ho Chi Minh, Vietnam (Presenter) Nothing to Disclose
Rajiv Chopra, PhD, Dallas, TX (Abstract Co-Author) Stockholder, Profound Medical Corporation; Stockholder, Solenic Medical Inc
Chandran Nadarajan, MD, Kota Bharu, Malaysia (Abstract Co-Author) Nothing to Disclose
Mohd Shafie Abdullah, MMed,RT, Kota Bharu, Malaysia (Abstract Co-Author) Nothing to Disclose
Bilgin Keserci, PhD, Kota Bharu, Malaysia (Abstract Co-Author) Nothing to Disclose
bsnguyenminhduc@pnt.edu.vn
PURPOSETo comparatively evaluate the therapeutic efficacy of the magnetic resonance imaging (MRI)-guided high-intensity focused ultrasound (HIFU) ablation of adenomyosis based on T1-perfusion and T2 signal intensity (SI)-based classifications.
METHOD AND MATERIALS50 women (age, 40.3 ± 6.0 years; range) who underwent HIFU treatment were classified according to (i) T2 SI-based classification as group I (focal adenomyosis, n = 32), group II (diffuse adenomyosis, n = 18,), and (ii) T1 perfusion-based classification as group A (if the time-signal intensity (SI) curve of lesion is lower than that of myometrium, n = 28) and group B (if the time-SI curve of lesion is equal to or higher than that of myometrium, n = 22). The adenomyosis volume, non-perfused volume (NPV) ratios immediately after treatment and volume reduction ratios and transformed symptom severity scores (tSSS) at the 6-month follow-up were retrospectively assessed.
RESULTSThe mean adenomyosis volume of group I, II, A, and B was 99.8ml and 126.5ml (p>0.05), 108.8ml and 110.2ml (p>0.05), respectively. The mean NPV ratio was significantly higher in group A than in group B (88.6% and 41.1%, respectively; p<0.05). No statistically significant difference was noted in the immediate NPV ratio among patients with the group I and II (64.9% and 72.6%, respectively; p>0.05). In group A, the mean NPV ratio was 89.6% (n = 16) for patients with focal adenomyosis and 87.3% (n = 12; p>0.05) for patients with diffuse adenomyosis. In group B, the mean NPV ratio was 41.1% (n = 22) for patients with focal adenomyosis and 40.3% (n = 6; p>0.05) for patients with diffuse adenomyosis. The 6-month adenomyosis volume reduction ratio in group A was significantly greater compared to that in group B (30.3% and 7.6%, respectively; p<0.05) whereas there was no statistically significant difference among the group I and II (19.5% and 21.7%, respectively; p>0.05). The tSSS improvement ratio was 46.4% and 47.3% in group I and II, and 72.2% and 14.3% in group A and B, respectively.
CONCLUSIONThe preliminary results of this study revealed that T1-perfusion based classification method could play an important role in classifying the adenomyosis and predicting the treatment outcome of MRI-guided HIFU ablation
CLINICAL RELEVANCE/APPLICATIONT1 perfusion-based classification is an important predictor of MRI-guided HIFU treatment outcome of adenomyosis and should be considered by the treating physician in the screening phase.