Share：
Share this content in WeChat
X
[Chinese][PDF]72331
• Clinical Article •
Development and assessment of a novel nomogram based on multiple parameters MRI for predicting the risk of reintervention after high intensity focused ultrasound treatment of uterine leiomyoma
ZENG Chaoqiang  WANG Jing  ZHANG Xiaoming  TANG Mengyue  GUO Zhiwei  CHEN Tianwu 

Cite this article as: Zeng CQ, Wang J, Zhang XM, et al. Development and assessment of a novel nomogram based on multiple parameters MRI for predicting the risk of reintervention after high intensity focused ultrasound treatment of uterine leiomyoma[J]. Chin J Magn Reson Imaging, 2022, 13(7): 68-74, 111. DOI:10.12015/issn.1674-8034.2022.07.012.


[Abstract] Objective To explore the risk factors of reintervention after high intensity focused ultrasound (HIFU) treatment of uterine leiomyoma based on magnetic resonance imaging (MRI) multiple parameters, and establish a novel nomogram for predicting the reintervention rate.Materials and Methods Patient cases with uterine leiomyoma treated with HIFU from March 2016 to December 2017 in our hospital were retrospectively investigated. Their MRI and clinical characteristics were noted. The reintervention treatment information of patients after HIFU was understood by telephone follow-up. Independent risk factors for reintervention after HIFU treatment of uterine leiomyoma were analyzed with Kaplan-Meier and Cox regression analysis. A nomogram model for predicting the probability of no further intervention 3 and 5 years after HIFU was established through R software. Meanwhile, its predictive performance is verified.Results A total of 191 patients with uterine leiomyoma who were treated with HIFU were recruited and the postoperative reintervention rate was 23.6% (45/191). Univariate analysis showed that age, leiomyoma volume, T2WI signal type, T1WI enhancement degree, Standard apparent diffusion coefficient value (StandardADC) and Slow ADC value (SlowADC) were potential risk factors. Multivariate Cox regression analysis showed that age, T2WI signal type, T1WI enhancement degree and SlowADC were independent prognostic factors for uterine leiomyoma treated with HIFU. The C-index of constructed nomogram is 0.745 (95% confidence interval: 0.672-0.818). The area under the curve (AUC) of 3-year and 5-year receiver operating characteristic (ROC) curves were 0.833 and 0.749. The calibration curve also confirms that the nomogram is in good agreement with the actual reintervention situation.Conclusions The nomogram model which combine MRI multi-parameters can be used to evaluate the reintervention of uterine leiomyoma 3 and 5 years after HIFU and may provide a reference basis for clinical personalized treatment.
[Keywords] high intensity focused ultrasound；reintervention；uterine leiomyoma；risk prediction；nomogram；magnetic resonance imaging；multiple parameters

ZENG Chaoqiang1, 2   WANG Jing1   ZHANG Xiaoming2*   TANG Mengyue2   GUO Zhiwei1   CHEN Tianwu2  

1 Department of Radiology, Nanchong Central Hospital/The Second Clinical College of North Sichuan Medical College, Nanchong 637000, China

2 Sichuan Key Laboratory of Medical Imaging/Department of Radiology, the Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China

Zhang XM, E-mail: cjr.zhxm@vip.163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS Major Cultivation Project of Sichuan Province Natural Science Foundation (No. 17CZ0014).
Received  2022-03-21
Accepted  2022-06-24
DOI: 10.12015/issn.1674-8034.2022.07.012
Cite this article as: Zeng CQ, Wang J, Zhang XM, et al. Development and assessment of a novel nomogram based on multiple parameters MRI for predicting the risk of reintervention after high intensity focused ultrasound treatment of uterine leiomyoma[J]. Chin J Magn Reson Imaging, 2022, 13(7): 68-74, 111. DOI:10.12015/issn.1674-8034.2022.07.012.

[1]
Diagnosis and treatment of uterine fibroids in China expert consensus expert group. Chinese experts' consensus on the diagnosis and treatment of hysteromyoma[J]. Chin J Obstet Gynecol, 2017, 52(12): 793-800. DOI: 10.3760/cma.j.issn.0529-567x.2017.12.001.
[2]
Hu L, Zhao JS, Xing C, et al. Comparison of focused ultrasound surgery and hysteroscopic resection for treatment of submucosal uterine fibroids (FIGO type 2)[J]. Ultrasound Med Biol, 2020, 46(7): 1677-1685. DOI: 10.1016/j.ultrasmedbio.2020.02.018.
[3]
Lang JH, Chen CL, Xiang Y, et al. Expert consensus of uterine artery embolization for uterine fibroids and adenomyosis[J]. Chin J Obstet Gynecol, 2018, 53(5): 289-293. DOI: 10.3760/cma.j.issn.0529-567x.2018.05.001.
[4]
Torres-de la Roche LA, Rafiq S, Devassy R, et al. Should Ultrasound-Guided High Frequency Focused Ultrasound Be Considered as an Alternative Non-Surgical Treatment of Uterine Fibroids in Non-Asiatic Countries? An Opinion Paper[J]. J Clin Med. 2022, 11(3):839. DOI: 10.3390/jcm11030839.
[5]
Gong X, Zhang XY, Liu D, et al. Physician experience in technical success of achieving NPVR ≥80% of high-intensity focused ultrasound ablation for uterine fibroids: a multicenter study[J]. Front Med Technol, 2022, 3: 790956. DOI: 10.3389/fmedt.2021.790956.
[6]
Verpalen IM, Anneveldt KJ, Nijholt IM, et al. Magnetic resonance-high intensity focused ultrasound (MR-HIFU) therapy of symptomatic uterine fibroids with unrestrictive treatment protocols: a systematic review and meta-analysis[J]. Eur J Radiol, 2019, 120: 108700. DOI: 10.1016/j.ejrad.2019.108700.
[7]
Chen J, Li Y, Wang Z, et al. Evaluation of high-intensity focused ultrasound ablation for uterine fibroids: an IDEAL prospective exploration study[J]. BJOG, 2018, 125(3): 354-364. DOI: 10.1111/1471-0528.14689.
[8]
Minimally Invasive Therapeutics Group of MRI Application Committee of China Medical Equipment Association. China consensus on MR-guided focused ultrasound for uterine fibroids[J]. Med J Peking Union Med Coll Hosp, 2020, 11(5): 571-579. DOI: 10.3969/j.issn.1674-9081.2020.05.012.
[9]
Zheng YN, Chen LP, Liu MQ, et al. Prediction of clinical outcome for high-intensity focused ultrasound ablation of uterine leiomyomas using multiparametric MRI radiomics-based machine leaning model[J]. Front Oncol, 2021, 11: 618604. DOI: 10.3389/fonc.2021.618604.
[10]
Yang MJ, Yu RQ, Chen WZ, et al. A prediction of NPVR ≥80% of ultrasound-guided high-intensity focused ultrasound ablation for uterine fibroids[J]. Front Surg, 2021, 8: 663128. DOI: 10.3389/fsurg.2021.663128.
[11]
Tang RJ, Zhao W, Zhang XX, et al. Efficacy and safety of uterine artery embolization and high-intensity focused ultrasound in the treatment of uterine fibroids[J]. J Pract Radiol, 2021, 37(8): 1344-1347. DOI: 10.3969/j.issn.1002-1671.2021.08.029.
[12]
Ning GC, Zhang XR, Zhang Q, et al. Real-time and multimodality image-guided intelligent HIFU therapy for uterine fibroid[J]. Theranostics. 2020, 10(10):4676-4693. DOI: 10.7150/thno.42830.
[13]
Kou L, Jing Y, Zhang YH. Effect of high-intensity ultrasound focusing treatment of uterine myoma[J]. Chin J Fam Plan, 2021, 29(5): 911-913. DOI: 10.3969/j.issn.1004-8189.2021.05.014.
[14]
Lyon PC, Rai V, Price N, et al. Ultrasound-guided high intensity focused ultrasound ablation for symptomatic uterine fibroids: preliminary clinical experience[J]. Ultraschall Med, 2020, 41(5): 550-556. DOI: 10.1055/a-0891-0729.
[15]
Li WX, Jiang ZY, Deng XL, et al. Long-term follow-up outcome and reintervention analysis of ultrasound-guided high intensity focused ultrasound treatment for uterine fibroids[J]. Int J Hyperthermia, 2020, 37(1): 1046-1051. DOI: 10.1080/02656736.2020.1807617.
[16]
Liu YC, Wu XY, Wu AD, et al. Ultrasound-guided high intensity focused ultrasound ablation for uterine fibroids: long-term outcomes and factors affecting local recurrence[J]. Int J Hyperthermia, 2021, 38(1): 1341-1348. DOI: 10.1080/02656736.2021.1973585.
[17]
Chang CT, Jeng CJ, Long CY, et al. High-intensity focused ultrasound treatment for large and small solitary uterine fibroids[J]. Int J Hyperthermia, 2022, 39(1): 485-489. DOI: 10.1080/02656736.2022.2039788.
[18]
Sainio T, Saunavaara J, Komar G, et al. Feasibility of T2 relaxation time in predicting the technical outcome of MR-guided high-intensity focused ultrasound treatment of uterine fibroids[J]. Int J Hyperthermia, 2021, 38(1): 1384-1393. DOI: 10.1080/02656736.2021.1976850.
[19]
Marinova M, Ghaei S, Recker F, et al. Efficacy of ultrasound-guided high-intensity focused ultrasound (USgHIFU) for uterine fibroids: an observational single-center study[J]. Int J Hyperth, 2021, 38(2): 30-38. DOI: 10.1080/02656736.2021.1939444.
[20]
Camp RL, Dolled-Filhart M, Rimm DL. X-tile: a new bio-informatics tool for biomarker assessment and outcome-based cut-point optimization[J]. Clin Cancer Res. 2004, 10(21):7252-9. DOI: 10.1158/1078-0432.CCR-04-0713.
[21]
Fan HJ, Cun JP, Yao RH, et al. A multivariate analysis of ablation rate of HIFU in the treatment of uterine fibroids[J]. J Pract Radiol, 2018, 34(9): 1427-1429, 1474. DOI: 10.3969/j.issn.1002-1671.2018.09.029.
[22]
Gong CM, Lin ZJ, Lv FJ, et al. Magnetic resonance imaging parameters in predicting the ablative efficiency of high-intensity focused ultrasound for uterine fibroids[J]. Int J Hyperthermia, 2021, 38(1): 523-531. DOI: 10.1080/02656736.2021.1904152.
[23]
Keserci B, Duc NM, Nadarajan C, et al. Volumetric MRI-guided, high-intensity focused ultrasound ablation of uterine leiomyomas: ASEAN preliminary experience[J]. Diagn Interv Radiol. 2020, 26(3):207-215. DOI: 10.5152/dir.2019.19157.
[24]
Yi GF, Zhao W, Fan HJ, et al. Effect of high-intensity focused ultrasound ablation on uterine fibroids with different signal intensity on T2WI[J]. J Pract Radiol, 2019, 35(3): 437-440. DOI: 10.3969/j.issn.1002-1671.2019.03.025.
[25]
Liu YN, Chen JY, Zhang R, et al. Relationship between quantitative detection of MR signal intensity and ablation effect of high intensity focused ultrasound for uterine fibroids[J]. Chin J Med Imaging, 2020, 28(6): 466-470. DOI: 10.3969/j.issn.1005-5185.2020.06.016.
[26]
Huang HR, Ran JB, Xiao ZB, et al. Reasons for different therapeutic effects of high-intensity focused ultrasound ablation on excised uterine fibroids with different signal intensities on T2-weighted MRI: a study of histopathological characteristics[J]. Int J Hyperthermia, 2019, 36(1): 477-484. DOI: 10.1080/02656736.2019.1592242.
[27]
Chen SY, Li CH, Zhou Y, et al. Effects of blood perfusion on high-intensity focused ultrasound ablation for uterine fibroids[J]. Chin J Med Phys, 2021, 38(11): 1412-1416. DOI: 10.3969/j.issn.1005-202X.2021.11.017.
[28]
Wei C, Fang X, Wang CB, et al. The predictive value of quantitative DCE metrics for immediate therapeutic response of high-intensity focused ultrasound ablation (HIFU) of symptomatic uterine fibroids[J]. Abdom Radiol (NY), 2018, 43(8): 2169-2175. DOI: 10.1007/s00261-017-1426-7.
[29]
Zhao LY, Liu S, Chen ZG, et al. Cavitation enhances coagulated size during pulsed high-intensity focussed ultrasound ablation in an isolated liver perfusion system[J]. Int J Hyperthermia, 2017, 33(3): 343-353. DOI: 10.1080/02656736.2016.1255918.
[30]
Chen FF, Yang ZM, Xu AL, et al. The role of VEGF in the occurrence and growth of uterine leiomyoma[J]. Pract J Cancer, 2018, 33(5): 704-706, 710. DOI: 10.3969/j.issn.1001-5930.2018.05.003.
[31]
Łoziński T, Ciebiera M, Łuczyńska E, et al. Magnetic Resonance-Guided High-Intensity Focused Ultrasound Ablation of Uterine Fibroids-Efficiency Assessment with the Use of Dynamic Contrast-Enhanced Magnetic Resonance Imaging and the Potential Role of the Administration of Uterotonic Drugs[J]. Diagnostics (Basel). 2021, 11(4):715. DOI: 10.3390/diagnostics11040715.
[32]
Andrews S, Yuan Q, Bailey A, et al. Multiparametric MRI characterization of funaki types of uterine fibroids considered for MR-guided high-intensity focused ultrasound (MR-HIFU) therapy[J]. Acad Radiol, 2019, 26(4): e9-e17. DOI: 10.1016/j.acra.2018.05.012.
[33]
Li HH, Sun B, Tan C, et al. The value of whole-tumor histogram and texture analysis using intravoxel incoherent motion in differentiating pathologic subtypes of locally advanced gastric cancer[J]. Front Oncol, 2022, 12: 821586. DOI: 10.3389/fonc.2022.821586.
[34]
Wu XP, Gao Y, Wu H, et al. IVIM in the differential diagnosis of brucellosis spondylitis, tuberculous spondylitis and spinal metastatic tumors[J]. J Clin Radiol, 2018, 37(5): 828-832. DOI: 10.13437/j.cnki.jcr.2018.05.029.
[35]
Ran YT, Bei GG. The correlation between intravoxel incoherent motion and microvessel density and pathological differentiation of cervical cancer[J]. Chin J Magn Reson Imaging, 2021, 12(7): 72-76. DOI: 10.12015/issn.1674-8034.2021.07.015.
[36]
Wei C, Wang CB, Li NY, et al. Diagnostic value of MR T2WI-based radiomics in distinguishing different pathological types of uterine fibroids[J]. J Clin Radiol, 2021, 40(12): 2329-2334. DOI: 10.13437/j.cnki.jcr.2021.12.019.
[37]
Jin HP, Yu FF, Zhao YP, et al. Preliminary analysis on the influence of different factors on the curative effects of high intensity focused ultrasound treatment of hysteromyoma[J]. J Wenzhou Med Coll, 2013, 43(6): 379-382. DOI: 10.13771/j.cnki.33-1386/r.2013.06.012.

PREV Preoperative predicting lymphov-ascular space invasion in endometrial carcinoma by nomogram based on mpMRI radiomics
NEXT Uncoupling between functional connectivity density and amplitude of low frequency fluctuation in childhood absence epilepsy
  


LINK


Tel & Fax: +8610-67113815    E-mail: editor@cjmri.cn