A Prediction of NPVR ≥ 80% of Ultrasound-Guided High-Intensity Focused Ultrasound Ablation for Uterine Fibroids

Abstract

Objective: To evaluate factors in predicting the treatment outcome of ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation for uterine fibroids with a non-perfused volume ratio (NPVR) of at least 80%.Methods: One thousand patients with uterine fibroids who received USgHIFU were enrolled. Thirty-two independent variables of four dimensions of data set, including general information of patients, clinical symptoms, laboratory tests, and fibroid imaging characteristics, were used to investigate the potential predictors of the NPVR of at least 80% by multivariate logistic regression. NPVR was the gold standard for evaluating the efficiency of HIFU ablation, and a NPVR of at least 80% was considered sufficient ablation, while partial ablation was defined as having an NPVR of <80%.Results: Out of 1,000 fibroids, 758 obtained sufficient ablation and 242 obtained partial ablation, and the median NPVR was 88.3% (interquartile range: 80.3–94.8%). The probability of NPVR reaching 80% fibroids with a signal intensity of T2WI of hypointense, isointense, and hyperintense was 86.4, 76.5, and 62.6%, respectively; fibroids with an enhancement type of T1WI of slight, irregular, and regular was 81.5, 73.6, and 63.7%, respectively; and fibroids with uterine anteroposterior of 30–130 mm was 57.7–78.3%, respectively. In patients with a platelet count of 50 × 109/L−550 × 109/L, the probability of NPVR reaching 80% is from 53.4 to 80.1%, respectively.Conclusions: In predicting NPVR ≥ 80%, the signal intensity on T2WI was the most important factor affecting ablative efficiency, followed by enhancement type on T1WI, uterine anteroposterior, and platelet count.

Physician Experience in Technical Success of Achieving NPVR ≥ 80% of High-Intensity Focused Ultrasound Ablation for Uterine Fibroids: A Multicenter Study

“…Park et al ( 31 ) reported that HIFU ablation of uterine fibroids achievement of an immediate NPVR of at least 80% was safe, with greater tumor volume shrinkage compared with cases with a lower NPVR. Recently, some scholars have set NPVR at least 80% as a measure of sufficient ablation indexes in HIFU treatment of uterine fibroids ( 32 ). In addition, some scholars investigated MRI screening parameters for predicting an NPV ratio of at least 90% ( 33 , 34 ).…”

Evaluation of physician experience in achieving non-perfused volume ratio of high-intensity focused ultrasound ablation for uterine fibroids: a multicentre study

“…14 Recently, researchers have set the NPVR at a minimum of 80% as a measure of sufficient ablation in the HIFU ablation therapy of uterine fibroids. 25,26 Even some researchers have shown that an NPVR of 90% can be used as a standard for the HIFU ablation therapy of uterine fibroids. 15,16 Among the 20 centres included in this current study, the aim was to obtain a higher NPVR on the premise of safety, so as to improve the clinical effect of HIFU ablation of uterine fibroids.…”

“… 14 Recently, researchers have set the NPVR at a minimum of 80% as a measure of sufficient ablation in the HIFU ablation therapy of uterine fibroids. 25 , 26 Even some researchers have shown that an NPVR of 90% can be used as a standard for the HIFU ablation therapy of uterine fibroids. 15 , 16 …”

Ultrasound-guided HIFU for uterine fibroids of hyperintense on T2-weighted MR imaging with or without GnRH-analogue-pretreated: A propensity score matched cohort study

“…Moreover, some studies showed that hyperintense fibroids could also be ablated with more ultrasonic energy than other signal intensity fibroids ( 7 , 8 ). Recently, a study proposed that the signal intensity on T2WI was the most important factor affecting ablative efficiency ( 9 ). Therefore, whether HIFU ablation is suitable for hyperintense fibroids on T2WI and which treatment protocol should be adopted has become a research hotspot.…”