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Τρίτη 7 Νοεμβρίου 2017

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

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



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