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Screening Magnetic Resonance Imaging-Based Prediction Model for Assessing Immediate Therapeutic Response to Magnetic Resonance Imaging-Guided High-Intensity Focused Ultrasound Ablation of Uterine Fibroids.

Publication ,  Journal Article
Kim, Y-S; Lim, HK; Park, MJ; Rhim, H; Jung, S-H; Sohn, I; Kim, T-J; Keserci, B
Published in: Invest Radiol
January 2016

OBJECTIVES: The aim of this study was to fit and validate screening magnetic resonance imaging (MRI)-based prediction models for assessing immediate therapeutic responses of uterine fibroids to MRI-guided high-intensity focused ultrasound (MR-HIFU) ablation. MATERIALS AND METHODS: Informed consent from all subjects was obtained for our institutional review board-approved study. A total of 240 symptomatic uterine fibroids (mean diameter, 6.9 cm) in 152 women (mean age, 43.3 years) treated with MR-HIFU ablation were retrospectively analyzed (160 fibroids for training, 80 fibroids for validation). Screening MRI parameters (subcutaneous fat thickness [mm], x1; relative peak enhancement [%] in semiquantitative perfusion MRI, x2; T2 signal intensity ratio of fibroid to skeletal muscle, x3) were used to fit prediction models with regard to ablation efficiency (nonperfused volume/treatment cell volume, y1) and ablation quality (grade 1-5, poor to excellent, y2), respectively, using the generalized estimating equation method. Cutoff values for achievement of treatment intent (efficiency >1.0; quality grade 4/5) were determined based on receiver operating characteristic curve analysis. Prediction performances were validated by calculating positive and negative predictive values. RESULTS: Generalized estimating equation analyses yielded models of y1 = 2.2637 - 0.0415x1 - 0.0011x2 - 0.0772x3 and y2 = 6.8148 - 0.1070x1 - 0.0050x2 - 0.2163x3. Cutoff values were 1.312 for ablation efficiency (area under the curve, 0.7236; sensitivity, 0.6882; specificity, 0.6866) and 4.019 for ablation quality (0.8794; 0.7156; 0.9020). Positive and negative predictive values were 0.917 and 0.500 for ablation efficiency and 0.978 and 0.600 for ablation quality, respectively. CONCLUSIONS: Screening MRI-based prediction models for assessing immediate therapeutic responses of uterine fibroids to MR-HIFU ablation were fitted and validated, which may reduce the risk of unsuccessful treatment.

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Published In

Invest Radiol

DOI

EISSN

1536-0210

Publication Date

January 2016

Volume

51

Issue

1

Start / End Page

15 / 24

Location

United States

Related Subject Headings

  • Uterine Neoplasms
  • Surgery, Computer-Assisted
  • Retrospective Studies
  • Predictive Value of Tests
  • Nuclear Medicine & Medical Imaging
  • Models, Theoretical
  • Middle Aged
  • Magnetic Resonance Imaging
  • Leiomyoma
  • Humans
 

Citation

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Kim, Y.-S., Lim, H. K., Park, M. J., Rhim, H., Jung, S.-H., Sohn, I., … Keserci, B. (2016). Screening Magnetic Resonance Imaging-Based Prediction Model for Assessing Immediate Therapeutic Response to Magnetic Resonance Imaging-Guided High-Intensity Focused Ultrasound Ablation of Uterine Fibroids. Invest Radiol, 51(1), 15–24. https://doi.org/10.1097/RLI.0000000000000199
Kim, Young-sun, Hyo Keun Lim, Min Jung Park, Hyunchul Rhim, Sin-Ho Jung, Insuk Sohn, Tae-Joong Kim, and Bilgin Keserci. “Screening Magnetic Resonance Imaging-Based Prediction Model for Assessing Immediate Therapeutic Response to Magnetic Resonance Imaging-Guided High-Intensity Focused Ultrasound Ablation of Uterine Fibroids.Invest Radiol 51, no. 1 (January 2016): 15–24. https://doi.org/10.1097/RLI.0000000000000199.

Published In

Invest Radiol

DOI

EISSN

1536-0210

Publication Date

January 2016

Volume

51

Issue

1

Start / End Page

15 / 24

Location

United States

Related Subject Headings

  • Uterine Neoplasms
  • Surgery, Computer-Assisted
  • Retrospective Studies
  • Predictive Value of Tests
  • Nuclear Medicine & Medical Imaging
  • Models, Theoretical
  • Middle Aged
  • Magnetic Resonance Imaging
  • Leiomyoma
  • Humans