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The predictive value of quantitative DCE metrics for immediate therapeutic response of high-intensity focused ultrasound ablation (HIFU) of symptomatic uterine fibroids

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PurposeThe aim of this study was to investigate the value of quantitative DCE-MRI parameters for predicting the immediate non-perfused volume ratio (NPVR) of HIFU therapy in the treatment of symptomatic… Click to show full abstract

PurposeThe aim of this study was to investigate the value of quantitative DCE-MRI parameters for predicting the immediate non-perfused volume ratio (NPVR) of HIFU therapy in the treatment of symptomatic uterine fibroids.Materials and methodsA total of 78 symptomatic uterine fibroids in 65 female patients were treated with US-HIFU therapy. All patients underwent conventional MRI and DCE-MRI scans 1 day before and 3 days after HIFU treatment. Permeability parameters Ktrans, Kep, Ve, and Vp and T1 perfusion parameters BF and BV of pretreatment were measured as a baseline, while NPVR was used to assess immediate ablation efficiency. Data were assigned to NPVR ≧ 70% and NPVR < 70% groups. Then, the predictive performances of different parameters for ablation efficacy were studied to seek the optimal cut-off value, and the length of time to calculate the variable parameters in each case was recorded.Results(1) It was observed that the pretreatment Ktrans, Kep, Ve, and BF values of the NPVR ≧ 70% group were significantly lower compared to the NPVR < 70% group (p < 0.05). (2) The immediate NPVR was negatively correlated with the Ktrans, BF, and BV values before HIFU treatment (r = − 0.561, − 0.712, and − 0.528, respectively, p < 0.05 for all). (3) The AUCs of pretreatment Ktrans, BF, BV values, and Ktrans combined with BF used to predict the immediate NPVR were 0.810, 0.909, 0.795, and 0.922, respectively (p < 0.05 for all). (4) The mean time to calculate the variable parameters in each case was 7.5 min.ConclusionHigher Ktrans, BF, and BV values at baseline DCE-MRI suggested a poor ablation efficacy of HIFU therapy for symptomatic uterine fibroids, while the pretreatment DCE-MRI parameters could be useful biomarkers for predicting the ablation efficacy in select cases. The software used to calculate DCE-MRI parameters was simpler, quicker, and easier to incorporate into clinical practice.

Keywords: dce; dce mri; ablation; uterine fibroids; symptomatic uterine

Journal Title: Abdominal Radiology
Year Published: 2017

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