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Clinical Article
Development and assessment of a novel nomogram based on multiple parameters MRI for predicting the risk of reintervention after high intensity focused ultrasound treatment of uterine leiomyoma
ZENG Chaoqiang  WANG Jing  ZHANG Xiaoming  TANG Mengyue  GUO Zhiwei  CHEN Tianwu 

Cite this article as: Zeng CQ, Wang J, Zhang XM, et al. Development and assessment of a novel nomogram based on multiple parameters MRI for predicting the risk of reintervention after high intensity focused ultrasound treatment of uterine leiomyoma[J]. Chin J Magn Reson Imaging, 2022, 13(7): 68-74, 111. DOI:10.12015/issn.1674-8034.2022.07.012.


[Abstract] Objective To explore the risk factors of reintervention after high intensity focused ultrasound (HIFU) treatment of uterine leiomyoma based on magnetic resonance imaging (MRI) multiple parameters, and establish a novel nomogram for predicting the reintervention rate.Materials and Methods Patient cases with uterine leiomyoma treated with HIFU from March 2016 to December 2017 in our hospital were retrospectively investigated. Their MRI and clinical characteristics were noted. The reintervention treatment information of patients after HIFU was understood by telephone follow-up. Independent risk factors for reintervention after HIFU treatment of uterine leiomyoma were analyzed with Kaplan-Meier and Cox regression analysis. A nomogram model for predicting the probability of no further intervention 3 and 5 years after HIFU was established through R software. Meanwhile, its predictive performance is verified.Results A total of 191 patients with uterine leiomyoma who were treated with HIFU were recruited and the postoperative reintervention rate was 23.6% (45/191). Univariate analysis showed that age, leiomyoma volume, T2WI signal type, T1WI enhancement degree, Standard apparent diffusion coefficient value (StandardADC) and Slow ADC value (SlowADC) were potential risk factors. Multivariate Cox regression analysis showed that age, T2WI signal type, T1WI enhancement degree and SlowADC were independent prognostic factors for uterine leiomyoma treated with HIFU. The C-index of constructed nomogram is 0.745 (95% confidence interval: 0.672-0.818). The area under the curve (AUC) of 3-year and 5-year receiver operating characteristic (ROC) curves were 0.833 and 0.749. The calibration curve also confirms that the nomogram is in good agreement with the actual reintervention situation.Conclusions The nomogram model which combine MRI multi-parameters can be used to evaluate the reintervention of uterine leiomyoma 3 and 5 years after HIFU and may provide a reference basis for clinical personalized treatment.
[Keywords] high intensity focused ultrasound;reintervention;uterine leiomyoma;risk prediction;nomogram;magnetic resonance imaging;multiple parameters

ZENG Chaoqiang1, 2   WANG Jing1   ZHANG Xiaoming2*   TANG Mengyue2   GUO Zhiwei1   CHEN Tianwu2  

1 Department of Radiology, Nanchong Central Hospital/The Second Clinical College of North Sichuan Medical College, Nanchong 637000, China

2 Sichuan Key Laboratory of Medical Imaging/Department of Radiology, the Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China

Zhang XM, E-mail: cjr.zhxm@vip.163.com

Conflicts of interest   None.

Received  2022-03-21
Accepted  2022-06-24
DOI: 10.12015/issn.1674-8034.2022.07.012
Cite this article as: Zeng CQ, Wang J, Zhang XM, et al. Development and assessment of a novel nomogram based on multiple parameters MRI for predicting the risk of reintervention after high intensity focused ultrasound treatment of uterine leiomyoma[J]. Chin J Magn Reson Imaging, 2022, 13(7): 68-74, 111.DOI:10.12015/issn.1674-8034.2022.07.012

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