Share：
Share this content in WeChat
X
[Chinese][PDF]5966
• Clinical Article •
Value of radiomics stacking ensemble learning model based on T2WI and CE-T1WI in predicting the efficacy of HIFU ablation of uterine fibroid
LI Chengwei  XIAO Zhibo  HE Zhimin  LÜ Fajin 

Cite this article as: LI C W, XIAO Z B, HE Z M, et al. Value of radiomics stacking ensemble learning model based on T2WI and CE-T1WI in predicting the efficacy of HIFU ablation of uterine fibroid[J]. Chin J Magn Reson Imaging, 2023, 14(6): 45-51. DOI:10.12015/issn.1674-8034.2023.06.007.


[Abstract] Objective To explore the value of the radiomics ensemble stacking model based on the combined sequences of T2WI and contrast enhancement T1WI (CE-T1WI) in predicting the efficacy of high intensity focused ultrasound (HIFU) ablation of uterine fibroids before surgery.Materials and Methods A total of 300 patients with uterine fibroids diagnosed clinically and treated with HIFU were retrospectively analyzed. Two physicians grouped patients into a full ablation group (nonperfusion volume ratio≥80%) and an incomplete ablation group (nonperfusion volume ratio＜80%), and used Kappa test to analyze the consistency of their grouping results. Then, all patients were randomly divided into a training set (n=240) and a test set (n=60) in the ratio of 8:2. ITK-SNAP software was used to delineate the region of interest of uterine fibroids on T2WI and CE-T1WI and extract the radiomics features. Two-sample t test and the least absolute shrinkage and selection operator were used for feature screening, and the retained features of the two sequences were used for subsequent model construction. The support vector machine, random forest, extreme gradient boosting and light gradient boosting machine were used as the basic learner to constructed base models (A, B, C, D) respectively, and the ensemble stacking model was constructed by Logistic regression as the meta-learner, and five-fold cross validation was conducted. The area under the receiver operating characteristic curve (AUC) was used to evaluate the performance of each model. maging data of the patients were analyzed by independent sample t-test or Wilcoxon rank sum test (including myoma volume, myoma type, T2WI signal strength, T2WI signal uniformity, CE-T1WI signal strength, CE-T1WI signal uniformity).Results There were 172 patients in the full ablation group and 128 patients in the incomplete ablation group, and the Kappa value was 0.939 (P＜0.001) after performing the Kappa test on the results of the patient grouping of the two physicians. After feature screening, 14 and 5 features were retained on T2WI and CE-T1WI, respectively. The average AUC of five-fold cross-validation of the four base models A, B, C and D on the test set were 0.832, 0.863, 0.861 and 0.880, respectively. The average AUC value of the ensemble stacking model constructed using 5 algorithms has been increased to 0.924. Statistical analysis demonstrated that there were statistically significant differences in fibroid volume, fibroid type, T2WI signal homogeneity and CE-T1WI signal intensity in the training set (P＜0.05), and statistically significant differences in fibroid type in the test set (P＜0.05).Conclusions The radiomics ensemble stacking model based on the combined sequences of T2WI and CE-T1WI can effectively predict the efficacy of HIFU ablation of uterine fibroids before surgery.
[Keywords] uterine fibroids；efficacy prediction；high intensity focused ultrasound；radiomics；ensemble stacking model；magnetic resonance imaging

LI Chengwei1   XIAO Zhibo2   HE Zhimin1   LÜ Fajin1, 2*  

1 State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing 400016, China

2 Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China

Corresponding author: Lü FJ, E-mail: fajinlv@163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS Foundation of State Key Laboratory of Ultrasound in Medicine and Engineering (No. 2022KFKT005).
Received  2023-01-10
Accepted  2023-05-18
DOI: 10.12015/issn.1674-8034.2023.06.007
Cite this article as: LI C W, XIAO Z B, HE Z M, et al. Value of radiomics stacking ensemble learning model based on T2WI and CE-T1WI in predicting the efficacy of HIFU ablation of uterine fibroid[J]. Chin J Magn Reson Imaging, 2023, 14(6): 45-51. DOI:10.12015/issn.1674-8034.2023.06.007.

[1]
BAIRD D D, DUNSON D B, HILL M C, et al. High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence[J]. Am J Obstet Gynecol, 2003, 188(1): 100-107. DOI: 10.1067/mob.2003.99.
[2]
DATIR S G, BHAKE A. Management of uterine fibroids and its complications during pregnancy: a review of literature[J/OL]. Cureus, 2022, 14(11): e31080 [2023-01-05]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9719606. DOI: 10.7759/cureus.31080.
[3]
BULUN S E. Uterine fibroids[J]. N Engl J Med, 2013, 369(14): 1344-1355. DOI: 10.1056/nejmra1209993.
[4]
STEWART E A, COOKSON C L, GANDOLFO R A, et al. Epidemiology of uterine fibroids: a systematic review[J]. BJOG, 2017, 124(10): 1501-1512. DOI: 10.1111/1471-0528.14640.
[5]
GIULIANI E, AS-SANIE S, MARSH E E. Epidemiology and management of uterine fibroids[J]. Int J Gynaecol Obstet, 2020, 149(1): 3-9. DOI: 10.1002/ijgo.13102.
[6]
ŁOZIŃSKI T, FILIPOWSKA J, GURYNOWICZ G, et al. The effect of high-intensity focused ultrasound guided by magnetic resonance therapy on obstetrical outcomes in patients with uterine fibroids-experiences from the main Polish center and a review of current data[J]. Int J Hyperthermia, 2019, 36(1): 582-590. DOI: 10.1080/02656736.2019.1616117.
[7]
WANG Y R, XU Y H, WONG F, et al. Preliminary study on ultrasound-guided high-intensity focused ultrasound ablation for treatment of broad ligament uterine fibroids[J]. Int J Hyperthermia, 2021, 38(2): 18-23. DOI: 10.1080/02656736.2021.1921287.
[8]
LIU X, TANG J, LUO Y, et al. Comparison of high-intensity focused ultrasound ablation and secondary myomectomy for recurrent symptomatic uterine fibroids following myomectomy: a retrospective study[J]. BJOG, 2020, 127(11): 1422-1428. DOI: 10.1111/1471-0528.16262.
[9]
LIU L, WANG T F, LEI B Y. High-intensity focused ultrasound (HIFU) ablation versus surgical interventions for the treatment of symptomatic uterine fibroids: a meta-analysis[J]. Eur Radiol, 2022, 32(2): 1195-1204. DOI: 10.1007/s00330-021-08156-6.
[10]
VERPALEN I M, ANNEVELDT K J, NIJHOLT I M, 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/OL]. Eur J Radiol, 2019, 120: 108700 [2023-01-05]. https://linkinghub.elsevier.com/retrieve/pii/S0720-048X(19)30350-X. DOI: 10.1016/j.ejrad.2019.108700.
[11]
GONG X, ZHANG X Y, LIU D, et al. Evaluation of physician experience in achieving non-perfused volume ratio of high-intensity focused ultrasound ablation for uterine fibroids: a multicentre study[J/OL]. J Int Med Res, 2022, 50(5): 3000605221102087 [2023-01-05]. https://journals.sagepub.com/doi/10.1177/03000605221102087. DOI: 10.1177/03000605221102087.
[12]
GONG X, LIU D, YANG M J, et al. Tolerance and efficacy of HIFU ablation for uterine fibroids NPVR ≥ 90%: a nested case-control study[J]. Int J Hyperthermia, 2022, 39(1): 946-951. DOI: 10.1080/02656736.2022.2093414.
[13]
VERPALEN I M, DE BOER J P, LINSTRA M, et al. The Focused Ultrasound Myoma Outcome Study (FUMOS); a retrospective cohort study on long-term outcomes of MR-HIFU therapy[J]. Eur Radiol, 2020, 30(5): 2473-2482. DOI: 10.1007/s00330-019-06641-7.
[14]
WANG Y, LIU X, WANG W, et al. Long-term clinical outcomes of US-guided high-intensity focused ultrasound ablation for symptomatic submucosal fibroids: a retrospective comparison with uterus-sparing surgery[J]. Acad Radiol, 2021, 28(8): 1102-1107. DOI: 10.1016/j.acra.2020.05.010.
[15]
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 Hyperthermia, 2021, 38(2): 30-38. DOI: 10.1080/02656736.2021.1939444.
[16]
LYON P C, 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.
[17]
SAJAN, ANDREWS, MD, et al. Multiparametric MRI characterization of funaki types of uterine fibroids considered for MR-guided high-intensity focused ultrasound (MR-HIFU) therapy[J/OL]. Acad Radiol, 2019, 26(4): e9-e17 [2023-01-05]. https://linkinghub.elsevier.com/retrieve/pii/S1076-6332(18)30254-X. DOI: 10.1016/j.acra.2018.05.012.
[18]
LIAO L, XU Y H, BAI J, et al. MRI parameters for predicting the effect of ultrasound-guided high-intensity focused ultrasound in the ablation of uterine fibroids[J]. Clin Radiol, 2023, 78(1): 61-69. DOI: 10.1016/j.crad.2022.09.112.
[19]
KESERCI B, DUC N M. The role of T1 perfusion-based classification in magnetic resonance-guided high-intensity focused ultrasound ablation of uterine fibroids[J]. Eur Radiol, 2017, 27(12): 5299-5308. DOI: 10.1007/s00330-017-4885-x.
[20]
MINDJUK I, TRUMM C G, HERZOG P, et al. MRI predictors of clinical success in MR-guided focused ultrasound (MRgFUS) treatments of uterine fibroids: results from a single centre[J]. Eur Radiol, 2015, 25(5): 1317-1328. DOI: 10.1007/s00330-014-3538-6.
[21]
HUANG H R, RAN J B, XIAO Z B, 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.
[22]
YOON S W, LEE C, KIM K A, et al. Contrast-enhanced dynamic MR imaging of uterine fibroids as a potential predictor of patient eligibility for MR guided focused ultrasound (MRgFUS) treatment for symptomatic uterine fibroids[J/OL]. Obstet Gynecol Int, 2010, 2010: 834275 [2023-01-05]. https://www.hindawi.com/journals/ogi/2010/834275. DOI: 10.1155/2010/834275.
[23]
ARADHANA M, VENKATESAN, MD, et al. Magnetic resonance imaging-guided volumetric ablation of symptomatic leiomyomata: correlation of imaging with histology[J/OL]. J Vasc Interv Radiol, 2012, 23(6): 786-794.e4 [2023-01-05]. https://linkinghub.elsevier.com/retrieve/pii/S1051-0443(12)00303-X. DOI: 10.1016/j.jvir.2012.02.015.
[24]
AWIWI M O, BADAWY M, SHAABAN A M, et al. Review of uterine fibroids: imaging of typical and atypical features, variants, and mimics with emphasis on workup and FIGO classification[J]. Abdom Radiol (NY), 2022, 47(7): 2468-2485. DOI: 10.1007/s00261-022-03545-x.
[25]
LAMBIN P, LEIJENAAR R T H, DEIST T M, et al. Radiomics: the bridge between medical imaging and personalized medicine[J]. Nat Rev Clin Oncol, 2017, 14(12): 749-762. DOI: 10.1038/nrclinonc.2017.141.
[26]
GILLIES R J, KINAHAN P E, HRICAK H. Radiomics: images are more than pictures, they are data[J]. Radiology, 2016, 278(2): 563-577. DOI: 10.1148/radiol.2015151169.
[27]
ZHENG Y N, CHEN L P, LIU M Q, et al. Prediction of clinical outcome for high-intensity focused ultrasound ablation of uterine leiomyomas using multiparametric MRI radiomics-based machine leaning model[J/OL]. Front Oncol, 2021, 11: 618604 [2023-01-05]. https://www.frontiersin.org/articles/10.3389/fonc.2021.618604/full. DOI: 10.3389/fonc.2021.618604.
[28]
QIN S Z, HUANG X H, WANG F, et al. Value of T2WI-FS radiomics combined with imaging features in predicting the efficacy of HIFU ablation of hysteromyoma[J]. Chin J Magn Reson Imaging, 2022, 13(5): 59-63, 69. DOI: 10.12015/issn.1674-8034.2022.05.011
[29]
JIANG Y, HUANG X H, QIN S Z, et al. Study on the value of predicting the therapeutic effect of HIFU ablation of uterus myoma based on enhanced MRI radiomics model[J]. J Clin Radiol, 2022, 41(11): 2095-2100. DOI: 10.3760/cma.j.issn.0529-567x.2017.12.001.
[30]
WOLPERT D. Stacked generalization[J]. Neural Netw, 1992, 5: 241-259. DOI: 10.1016/S0893-6080(05)80023-1.
[31]
FERNANDEZ A, GARCIA S, HERRERA F, et al. SMOTE for learning from imbalanced data: progress and challenges, marking the 15-year anniversary[J/OL]. Jair, 2018, 61: 863-905 [2023-01-05]. http://www.jair.org/index.php/jair/article/view/11192. DOI: 10.1613/jair.1.11192.
[32]
VERPALEN I M, ANNEVELDT K J, VOS P C, et al. Use of multiparametric MRI to characterize uterine fibroid tissue types[J]. MAGMA, 2020, 33(5): 689-700. DOI: 10.1007/s10334-020-00841-9.
[33]
GONG C M, SETZEN R, LIU Z Q, et al. High intensity focused ultrasound treatment of adenomyosis: the relationship between the features of magnetic resonance imaging on T2 weighted images and the therapeutic efficacy[J]. Eur J Radiol, 2017, 89: 117-122. DOI: 10.1016/j.ejrad.2017.02.001.
[34]
LIU Z Q, GONG C M, LIU Y C, et al. Establishment of a scoring system for predicting the difficulty level of high-intensity focussed ultrasound ablation of uterine fibroids[J]. Int J Hyperthermia, 2018, 34(1): 77-86. DOI: 10.1080/02656736.2017.1325015.
[35]
YANG M J, YU R Q, CHEN W Z, et al. A prediction of NPVR≥80% of ultrasound-guided high-intensity focused ultrasound ablation for uterine fibroids[J/OL]. Front Surg, 2021, 8: 663128 [2023-01-05]. https://doi.org/10.3389/fsurg.2021.663128. DOI: 10.3389/fsurg.2021.663128.

PREV Brain regional homogeneity alterations in multi-frequency bands in primary dysmenorrhea: A resting-state functional magnetic resonance imaging study
NEXT MRI features of sacroiliac joint bone marrow fat-saturated T2WI high signal in osteitis condensans ilii
  


LINK


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