Non-contrast enhanced MRI for efficiency evaluation of high-intensity focused ultrasound in adenomyosis ablation

Abstract

Objective

To investigate the value of T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI) in evaluating the therapeutic effect of high-intensity focused ultrasound (HIFU) in adenomyosis ablation.

Material and methods

One hundred eighty-nine patients with adenomyosis were treated with HIFU. The ablation areas on T2WI and DWI sequences were classified into different types: type I, relatively ill-defined rim or unrecognizable; subtype IIa, well-defined rim with hyperintensity; subtype IIb, well-defined rim with hypointensity. The volume of ablation areas on T2WI (V_T2WI) and DWI (V_DWI) was measured and compared with the non-perfused volume (NPV), and linear regression was conducted to analyze their correlation with NPV.

Results

The V_T2WI of type I and type II (subtype IIa and subtype IIb) were statistically different from the corresponding NPV (p = 0.004 and 0.024, respectively), while no significant difference was found between the V_DWI of type I and type II with NPV (p = 0.478 and 0.561, respectively). In the linear regression analysis, both V_T2WI and V_DWI were positively correlated with NPV, with R² reaching 0.96 and 0.97, respectively.

Conclusions

Both T2WI and DWI have the potential for efficient evaluation of HIFU treatment in adenomyosis, and DWI can be a replacement for CE-T1WI to some extent.

Keywords:

• High-intensity focused ultrasound
• magnetic resonance imaging
• adenomyosis
• non-perfused volume
• efficiency evaluation

Author contributions

Si Ma: manuscript writing, data management, and analysis. Mingmei Tang, Xueke Qiu, and Yang Liu (third author): Classification and ROI delineation. Chunmei Gong: Conceptualization. Yan Hu: chart drawing. Fajin Lv and Yang Liu: project development and administration.

Ethical approval

The protocol of this retrospective study was approved by the Ethics Committee, and the requirement for informed consent was waived (ethics approval number K2023-115). All patient data were anonymized for reporting purposes.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The authors confirm that data supporting the findings of this study are available upon request from the corresponding author. The data are not publicly available because they contain information that can compromise the privacy of the research participants.