Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
European Radiology
Published in: European Radiology 12/2017

01-12-2017 | Magnetic Resonance

The role of T1 perfusion-based classification in magnetic resonance-guided high-intensity focused ultrasound ablation of uterine fibroids

Authors: Bilgin Keserci, Nguyen Minh Duc

Published in: European Radiology | Issue 12/2017

Login to get access

Abstract

Objective

To comparatively evaluate the role of magnetic resonance (MR) T1 perfusion-based time–signal intensity (SI) curves of fibroid tissue and the myometrium in classification of fibroids for predicting treatment outcomes of high-intensity focused ultrasound (HIFU) treatment.

Methods

The fibroids of 74 women who underwent MR-HIFU treatment were classified into group A (time–SI curve of fibroid lower than that of the myometrium) and group B (time–SI curve of fibroid equal to or higher than that of the myometrium). Non-perfused volume (NPV) ratios immediately after treatment and fibroid volume reduction ratios and symptom severity scores (SSS) at the 6-month follow-up were retrospectively assessed.

Results

The immediate NPV ratios in groups A and B were 95.3 ± 6.3% (n = 62) and 63.8 ± 11% (n = 12), respectively. At the 6-month follow-up, the fibroid volume reduction ratios in groups A and B were 0.52 ± 0.14 (n = 50) and 0.07 ± 0.14 (n = 11), with the corresponding improvement in mean transformed SSS being 0.86 ± 0.14 and 0.19 ± 0.3, respectively. No serious adverse effects were reported.

Conclusions

Our novel classification method could play an important role in classifying fibroids for predicting the immediate outcomes of HIFU treatment.

Key Points

• MRI is an important modality for outcome prediction in HIFU treatment
• Patient selection is a significant factor for achieving high NPV ratio
• NPV ratio is very strongly correlated with T1 perfusion-based classification
• T1 perfusion-based classification is a strong predictor of treatment outcome
Literature
1.
2.
Zowall H, Cairns JA, Brewer C et al (2008) Cost-effectiveness of magnetic resonance-guided focused ultrasound surgery for treatment of uterine fibroids. BJOG 115:653–662CrossRefPubMedPubMedCentral
3.
Pritts EA, Parker WH, Olive DL (2009) Fibroids and infertility: an updated systematic review of the evidence. Fertil Steril 91:1215–1223CrossRefPubMed
4.
Funaki K, Fukunishi H, Funaki T et al (2007) Magnetic resonance-guided focused ultrasound surgery for uterine fibroids: relationship between the therapeutic effects and SI of preexisting T2 weighted magnetic resonance images. Am J Obstet Gynecol 196:184.e181–184.e186CrossRef
5.
Stewart EA, Gostout B, Rabinovici J et al (2007) Sustained relief of leiomyoma symptoms by using focused ultrasound surgery. Obstet Gynecol 110:279–287CrossRefPubMed
6.
Lenard ZM, McDannold NJ, Fennessy FM et al (2008) Uterine leiomyomas: MR imaging-guided focused ultrasound surgery-imaging predictors of success. Radiology 249:187–194CrossRefPubMedPubMedCentral
7.
LeBlang SD, Hoctor K, Steinberg FL (2010) Leiomyoma shrinkage after MRI-guided focused ultrasound treatment: report of 80 patients. AJR Am J Roentgenol 194:274–280CrossRefPubMed
8.
Kim HS, Baik JH, Pham LD et al (2011) MR-guided high-intensity focused ultrasound treatment for symptomatic uterine leiomyomata: long-term outcomes. Acad Radiol 18:970–976CrossRefPubMedPubMedCentral
9.
Dobrotwir A, Pun E (2012) Clinical 24 month experience of the first MRgFUS unit for treatment of uterine fibroids in Australia. J Med Imaging Radiat Oncol 56:409–416CrossRefPubMed
10.
Machtinger R, Inbar Y, Cohen-Eylon S et al (2012) MR-guided focus ultrasound (MRgFUS) for symptomatic uterine fibroids: predictors of treatment success. Hum Reprod 27:3425–3431CrossRefPubMed
11.
Trumm CG, Stahl R, Clevert D-A et al (2013) Magnetic resonance imaging-guided focused ultrasound treatment of symptomatic uterine fibroids: impact of technology advancement on ablation volumes in 115 patients. Investig Radiol 48:359–365CrossRef
12.
Yoon SW, Lee C, Kim KA et al (2010) 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. Obstet Gynecol Int. doi:10.​1155/​2010/​834275
13.
Mindjuk I, Trumm CG, Herzog P et al (2015) MRI predictors of clinical success in MR-guided focused ultrasound (MRgFUS) treatments of uterine fibroids: results from a single centre. Eur Radiol 25:1317–1328CrossRefPubMed
14.
Gizzo S, Saccardi C, Patrelli TS et al (2014) Magnetic resonance-guided focused ultrasound myomectomy: safety, efficacy, subsequent fertility and quality-of-life improvements, a systematic review. Reprod Sci 21:465–476CrossRefPubMed
15.
16.
Köhler MO, Mougenot C, Quesson B et al (2009) Volumetric HIFU ablation under 3D guidance of rapid MRI thermometry. Med Phys 36:3521–3535CrossRef
17.
Spies JB, Coyne K, Guaou Guaou N et al (2002) The UFS-QOL, a new disease-specific symptom and health-related quality of life questionnaire for leiomyomata. Obstet Gynecol 99:290–300PubMed
18.
Sacks D, McClenny TE, Cardella JF et al (2003) Society of Interventional Radiology clinical practice guidelines. J Vasc Interv Radiol 14:S199–S202CrossRefPubMed
19.
Lin CN, Liao YS, Chen WC et al (2016) Use of myometrium as an internal reference for endometrial and cervical cancer on multiphase contrast enhanced MRI. PLoS One 11, e0157820CrossRefPubMedPubMedCentral
20.
Ikink ME, Voogt MJ, Verkooijen HM et al (2013) Mid-term clinical efficacy of a volumetric magnetic resonance-guided high-intensity focused ultrasound technique for treatment of symptomatic uterine fibroids. Eur Radiol 23:3054–3061CrossRefPubMed
21.
Zhao WP, Chen JY, Chen WZ (2015) Effect of biological characteristics of different types of uterine fibroids, as assessed with T2- weighted magnetic resonance imaging, on ultrasound-guided high-intensity focused ultrasound ablation. Ultrasound Med Biol 41:423–431CrossRefPubMed
22.
Pennes HH (1948) Analysis of tissue and arterial blood temperatures in the resting human forearm. J Appl Physiol 1:93–122PubMed
23.
Park MJ, Kim YS, Rhim HC et al (2014) Safety and therapeutic efficacy of complete or near-complete ablation of symptomatic uterine fibroid tumors by MR imaging-guided high-intensity focused US therapy. J Vasc Interv Radiol 25:231–239CrossRefPubMed
24.
Chen R, Keserci B, Bi H et al (2016) The safety and effectiveness of volumetric magnetic resonance-guided high intensity focused ultrasound treatment of symptomatic uterine fibroids: Early clinical experience in China. J Ther Ultrasound 4:27CrossRefPubMedPubMedCentral
25.
Hindley J, Gedroyc WM, Regan L et al (2004) MRI guidance of focused ultrasound therapy of uterine fibroids: early results. AJR Am J Roentgenol 183:1713–1719CrossRefPubMed
Metadata
Title
The role of T1 perfusion-based classification in magnetic resonance-guided high-intensity focused ultrasound ablation of uterine fibroids
Authors
Bilgin Keserci
Nguyen Minh Duc
Publication date
01-12-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 12/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-4885-x

Other articles of this Issue 12/2017

European Radiology 12/2017 Go to the issue

Chest

CT assessment-based direct surgical resection of part-solid nodules with solid component larger than 5 mm without preoperative biopsy: experience at a single tertiary hospital

Magnetic Resonance

Differentiating metastatic from nonmetastatic lymph nodes in cervical cancer patients using monoexponential, biexponential, and stretched exponential diffusion-weighted MR imaging

Breast

The role of cone-beam breast-CT for breast cancer detection relative to breast density

Computer Applications

Comparison of medical-grade and calibrated consumer-grade displays for diagnosis of subtle bone fissures

Breast

Post-clip placement MRI following second-look US-guided core biopsy for suspicious lesions identified on breast MRI

Urogenital

The longitudinal effect of ejaculation on seminal vesicle fluid volume and whole-prostate ADC as measured on prostate MRI