Histogram analysis of apparent diffusion coefficient for preoperative prediction of mid-term efficacy of high-intensity focused ultrasound in the treatment of uterine fibroids
This study was designed to investigate the preoperative prediction of the mid-term efficacy of high-intensity focused ultrasound (HIFU) in the treatment of uterine fibroids by apparent diffusion coefficient (ADC) histogram analysis. Eighty-six patients with a total of 101 uterine fibroids were retrospectively collected consecutively. The region of interest (ROI) was outlined layer by layer on diffusion-weighted imaging (DWI) images with b = 1000 s/mm The markedly effective group included 42 fibroids, and the noneffective group included 59 fibroids. The results of the univariate analysis showed that ADCmean, ADCmax, ADC10th, ADC25th, skewness, kurtosis, and entropy were significantly different between the two groups. The results of the multivariate analysis showed that ADC10th and skewness were statistically significant indicators, the area under the ROC curve (AUC) was 0.678 and 0.739, respectively, and the combined AUC of the two was 0.790. Major study limitations include: this is a single-center retrospective study, the investigator manually segmented the lesions, and no further analysis of postoperative pathology regarding the findings of the study. ADC histogram analysis helps to preoperatively predict the mid-term efficacy of HIFU in the treatment of uterine fibroids. ADC10th and skewness are independent predictors of the mid-term efficacy of HIFU, and the combined efficacy of the two is superior to that of a single indicator.