The Predictive Effect of Quantitative Analysis of Signal Intensity Heterogeneity on T2-Weighted MR Images for High-intensity Focused Ultrasound Treatment of Uterine Fibroids

Lu Wang; Yang Liu; Jinfeng Lin; Yuanrui Pan; Yang Liu; Fajin Lv

doi:10.1016/j.acra.2024.04.023

The Predictive Effect of Quantitative Analysis of Signal Intensity Heterogeneity on T2-Weighted MR Images for High-intensity Focused Ultrasound Treatment of Uterine Fibroids

Acad Radiol. 2024 May 3:S1076-6332(24)00232-0. doi: 10.1016/j.acra.2024.04.023. Online ahead of print.

Authors

Lu Wang¹, Yang Liu², Jinfeng Lin¹, Yuanrui Pan¹, Yang Liu¹, Fajin Lv³

Affiliations

¹ State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Yixueyuan Road, Yuzhong District, Chongqing 400016, China (L.W., J.L., Y.P., Y.L., F.L.); Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Yixueyuan Road, Yuzhong District, Chongqing 400016, China (L.W., J.L., Y.P., Y.L., F.L.).
² Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuanjiagang, Yuzhong District, Chongqing 400016, China (Y.L., F.L.).
³ State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Yixueyuan Road, Yuzhong District, Chongqing 400016, China (L.W., J.L., Y.P., Y.L., F.L.); Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Yixueyuan Road, Yuzhong District, Chongqing 400016, China (L.W., J.L., Y.P., Y.L., F.L.); Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuanjiagang, Yuzhong District, Chongqing 400016, China (Y.L., F.L.). Electronic address: fajinlv@163.com.

PMID: 38704283
DOI: 10.1016/j.acra.2024.04.023

Abstract

Rationale and objectives: To investigate whether the quantitative index of signal intensity (SI) heterogeneity on T2-weighted (T2W) magnetic resonance images can predict the difficulty and efficacy of high-intensity focused ultrasound (HIFU) ablation for uterine fibroids.

Materials and methods: The standard deviation (SD) of T2W image (T2WI) SI was used to quantify SI heterogeneity. The correlation between SD and the non-perfused volume ratio (NPVR) in 575 patients undergoing HIFU treatment was retrospectively analyzed, and the efficacy of SD in predicting NPVR was discussed. Three classifications were made based on the SD, and the ablation difficulty and ablation effect of different grades were compared. A total of 65 cases from another center were used as an external validation set to verify the classification performance of SD.

Results: The SD of SI was negatively correlated with NPVR (r = -0.460, p < 0.001). The predictive efficiency of SD for the ablation effect was higher than that of the scaled signal intensity (0.767 vs. 0.701, p = 0.006). Univariate and multivariate logistic regression analyses showed that SD was an independent predictor of ablation effect. Based on SD, the three classifications were divided into SD I: SD < 101.0, SD II: 101.0 ≤ SD < 138.7, and SD III: SD≥ 138.7. The treatment time, sonication time, treatment intensity, and total energy of SD I were lower than those of SD II and III (p < 0.05).

Conclusion: The heterogeneity of T2WI SI of uterine fibroids is negatively correlated with NPVR. The SD of SI can be used to predict the ablation difficulty and ablation effect of HIFU.

Keywords: High intensity focused ultrasound; Quantitative analysis; Standard deviation; T2-weighted image; Uterine fibroids.