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Erschienen in:
14.06.2017 | Magnetic Resonance
The role of T1 perfusion-based classification in magnetic resonance-guided high-intensity focused ultrasound ablation of uterine fibroids
Erschienen in: European Radiology | Ausgabe 12/2017
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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