Bilgin Keserci1,2, Nguyen Minh Duc3. 1. a Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia. 2. b Hospital Universiti Sains Malaysia, USM 16150 Kubang Kerian, Kelantan, Malaysia. 3. c Department of Radiology , Pham Ngoc Thach University of Medicine , Ho Chi Minh City , Viet Nam.
Abstract
OBJECTIVE: This retrospective study aimed (1) to investigate the magnetic resonance imaging (MRI) features influencing a nonperfused volume ratio (NPVr) ≥ 90% after high-intensity focussed ultrasound (HIFU) ablation of adenomyosis, and (2) to assess the safety, which was defined in terms of adverse events (AEs) and changes in anti-Mullerian hormone (AMH) concentrations, and clinical efficacy, which was defined in terms of adenomyosis volume reduction and symptom improvement at 6 months' follow-up. METHODS: Sixty-six women who underwent HIFU treatment were divided into groups A (NPVr ≥90%; n = 26) and B (NPVr <90%, n = 40). Multivariate logistic regression analyses of MRI features were conducted to identify the potential predictors of an NPVr ≥90%. RESULTS: Generalized estimating equation (GEE) analysis was used to model the prediction of an NPVr ≥90% with four significant predictors from multivariate analyses: the thickness of the subcutaneous fat layer, adenomyosis volume, T2 signal intensity (SI) ratio of adenomyosis to myometrium, and the Ktrans ratio of adenomyosis to myometrium. Clinical efficacy was significantly greater in group A than in group B. The findings showed no serious AEs and no significant differences between AMH concentrations before and 6 months after treatment. CONCLUSIONS: The present retrospective study demonstrated that achievement of NPVr ≥90% as a measure of clinical treatment success in MRI-guided HIFU treatment of adenomyosis using multivariate analyses and a prediction model is clinically possible without compromising the safety of patients.
OBJECTIVE: This retrospective study aimed (1) to investigate the magnetic resonance imaging (MRI) features influencing a nonperfused volume ratio (NPVr) ≥ 90% after high-intensity focussed ultrasound (HIFU) ablation of adenomyosis, and (2) to assess the safety, which was defined in terms of adverse events (AEs) and changes in anti-Mullerian hormone (AMH) concentrations, and clinical efficacy, which was defined in terms of adenomyosis volume reduction and symptom improvement at 6 months' follow-up. METHODS: Sixty-six women who underwent HIFU treatment were divided into groups A (NPVr ≥90%; n = 26) and B (NPVr <90%, n = 40). Multivariate logistic regression analyses of MRI features were conducted to identify the potential predictors of an NPVr ≥90%. RESULTS: Generalized estimating equation (GEE) analysis was used to model the prediction of an NPVr ≥90% with four significant predictors from multivariate analyses: the thickness of the subcutaneous fat layer, adenomyosis volume, T2 signal intensity (SI) ratio of adenomyosis to myometrium, and the Ktrans ratio of adenomyosis to myometrium. Clinical efficacy was significantly greater in group A than in group B. The findings showed no serious AEs and no significant differences between AMH concentrations before and 6 months after treatment. CONCLUSIONS: The present retrospective study demonstrated that achievement of NPVr ≥90% as a measure of clinical treatment success in MRI-guided HIFU treatment of adenomyosis using multivariate analyses and a prediction model is clinically possible without compromising the safety of patients.
Entities:
Keywords:
Adenomyosis; clinical efficacy; high-intensity focussed ultrasound; magnetic resonance imaging; nonperfused volume ratio; prediction model
Authors: Ferdinando Antonio Gulino; Valentina Dilisi; Stella Capriglione; Francesco Cannone; Francesco Catania; Francesco Giuseppe Martire; Attilio Tuscano; Marianna Gulisano; Valentina D'Urso; Alessandra Di Stefano; Monia Caterina Cimino; Maurizio Filippini; Silvia Latella; Margaret Sammarini; Giulia Musmeci; Marco Antonio Palumbo Journal: Front Endocrinol (Lausanne) Date: 2022-08-31 Impact factor: 6.055