Intratumoral and peritumoral radiomics for preoperative prediction of the efficacy of HIFU ablation for uterine fibroids based on multiparametric MRI: a multicenter study

TL;DR

This study shows that combining tumor and surrounding tissue imaging features can predict how well HIFU treatment will work for uterine fibroids.

Contribution

A novel radiomics model integrating intratumoral and peritumoral regions improves preoperative prediction of HIFU ablation efficacy.

Findings

T-PTRs radiomics models outperformed intratumoral models in predicting HIFU efficacy.

Combining T2WI and CE-T1WI features improved model performance with an AUC of 0.892 on internal testing.

The model achieved an AUC of 0.828 on external validation, showing robustness across centers.

Abstract

To assess the predictive value of intratumoral and multiregion peritumoral radiomics based on multiparametric MRI for preoperatively predicting the efficacy of high-intensity focused ultrasound (HIFU) ablation of uterine fibroids.

This retrospective study included 360 patients with uterine fibroids treated with high-intensity focused ultrasound (HIFU) at Center A (training set: N = 240; internal testing set: N = 60) and Center B (external testing set: N = 60). Patients were grouped into sufficient or insufficient ablation categories based on postoperative non-perfusion volume ratio. Intratumoral regions (TRs) were manually delineated on T2-weighted imaging (T2WI) and contrast-enhanced T1-weighted imaging (CE-T1WI). Peritumoral regions (PTRs) were generated by expanding the tumor boundary by 1 mm, 3 mm, and 5 mm. Radiomics features were extracted from TRs and PTRs on both MRI sequences. Key features for preoperative prediction were selected using t-tests, Pearson correlation, and LASSO regression. Support vector machine (SVM) models were built for TRs from T2WI and CE-T1WI, and for combined intratumoral and peritumoral regions (T-PTRs). A fusion model integrated optimal T-PTRs features from both sequences. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC).

The T-PTRs radiomics models outperformed the TR models, with the T-PTRs (3 mm) model demonstrating optimal performance. The integration of T2WI and CE-T1WI further enhanced the T-PTRs model, yielding an AUC of 0.892(0.814-0.969) on the internal test set and an AUC of 0.828(0.741 - 0.915) on the external validation set.

The predictive model based on intratumoral and peritumoral radiomics features serves as a valuable tool for predicting the therapeutic efficacy of HIFU ablation of uterine fibroids.

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