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• Clinical Article •
Study of ADC minimum in combination with clinical and imaging features for prediction of HIFU efficacy in treatment of uterine fibroids
LIU Ziyan  HUANG Xiaohua  LIU Ziyi  WANG Yuan  WAN Xiyao  JIANG Yu 

Cite this article as: LIU Z Y, HUANG X H, LIU Z Y, et al. Study of ADC minimum in combination with clinical and imaging features for prediction of HIFU efficacy in treatment of uterine fibroids[J]. Chin J Magn Reson Imaging, 2024, 15(9): 101-106. DOI:10.12015/issn.1674-8034.2024.09.017.


[Abstract] Objective Construct a model to predict the clinical efficacy of high intensity focused ultrasound (HIFU) in treating uterine fibroids based on the apparent diffusion coefficient minimum (ADCmin) and clinical and imaging features.Materials and Methods Clinical and imaging data of 153 patients who underwent HIFU treatment for uterine fibroids from September 2021 to December 2023 and met the criteria for inclusion were retrospectively collected, and a total of 153 fibroids were included in the study (choosing the largest in cases with multiple). Ultrasound assessed the fibroids' volume reduction rate three months after HIFU treatment, categorizing them into a significantly effective group (≥50% volume reduction, n=62) and a non-effective group (<50% volume reduction, n=91). Measurements were taken for the uterine fibroids' ADCmin and apparent diffusion coefficient mean (ADCmean). Univariate and multivariate logistic regression analyses were performed on clinical and imaging data, identifying factors to establish a clinical imaging feature model. Receiver operating characteristic (ROC) curves compared the predictive performance of uterine fibroids' ADCmin and ADCmean. A combined model was constructed by integrating the quantifiable indicator with high predictive efficiency, ADCmin, and the clinical imaging feature model. ROC evaluation and DeLong test compared the area under the curve (AUC) differences between ADCmin, the clinical imaging feature model, and the combined model.Results Hemoglobin, body mass index (BMI), and T1WI enhancement signal intensity were identified as factors to establish a clinical imaging feature model. The ROC curve demonstrates that the AUC values for ADCmin and ADCmean were 0.753 [95% confidence interval (CI): 0.677-0.828] and 0.658 (95% CI: 0.570-0.746), respectively. The DeLong test results show that ADCmin demonstrates higher predictive performance than ADCmean (P<0.05). The AUC values for the clinical imaging feature model and the combined ADCmin and clinical imaging feature model were 0.711 (95% CI: 0.627-0.796) and 0.816 (95% CI: 0.748-0.884), respectively. DeLong test indicates that the difference in AUC between ADCmin and the clinical imaging model is not statistically significant (P>0.05). The predictive efficacy of the combined model of ADCmin and clinical imaging features surpasses that of ADCmin alone (P<0.05) and the clinical imaging feature model (P<0.05).Conclusions The combined model constructed by ADCmin and clinical and imaging features can effectively predict the clinical efficacy of HIFU in the treatment of uterine fibroids, and can offer valuable insights for formulating clinical treatment strategies.
[Keywords] uterine fibroids；high intensity focused ultrasound；magnetic resonance imaging；apparent diffusion coefficient；prediction

LIU Ziyan   HUANG Xiaohua*   LIU Ziyi   WANG Yuan   WAN Xiyao   JIANG Yu  

Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China

Corresponding author: HUANG X H, E-mail: 15082797553@163.com

Conflicts of interest   None.

Received  2024-04-15
Accepted  2024-08-09
DOI: 10.12015/issn.1674-8034.2024.09.017
Cite this article as: LIU Z Y, HUANG X H, LIU Z Y, et al. Study of ADC minimum in combination with clinical and imaging features for prediction of HIFU efficacy in treatment of uterine fibroids[J]. Chin J Magn Reson Imaging, 2024, 15(9): 101-106. DOI:10.12015/issn.1674-8034.2024.09.017.

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