- 주저자 : Kim YS(김영선), Lim HK, Kim JH, Rhim, H, Park BK, Keserci B, Kohler MO, Bae DS, Kim BG, Lee JW, Kim TJ, Sokka S, Lee JH
- 영문 제목 : Dynamic contrast-enhanced MRI predicts immediate therapeutic response of MR-guided high-intensity focused ultrasound ablation of symptomatic uterine fibroids
- 한글 제목 : 유증상 자궁근종에 대한 MR하이푸 치료 후 치료효과 예측에 있어 관류MRI의 역할에 대한 연구
- 저널 : Invest Radiol
- 연도 : 2011
- 권 / 쪽 : 46 / 639-647
- 초록
OBJECTIVES:
: To evaluate dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters in the prediction of the immediate therapeutic response of MR-guided high-intensity focused ultrasound (HIFU) therapy in the treatment of symptomatic uterine fibroids
MATERIALS AND METHODS:
: Institutional review board approved this study, and informed consent was obtained from all participants. A total of 10 symptomatic uterine fibroids (diameter: mean, 8.9 cm; range, 4.7-12 cm) in 10 female patients (mean age, 42.2 years) were treated with MR-HIFU therapy using the volumetric ablation technique. DCE-MRI and conventional contrast-enhanced MRI were obtained as a baseline and as an immediate follow-up study, respectively. After regions of interest of each treatment cell were properly registered to both MRI studies, DCE-MRI parameters (K, ve, vp) and operator-controllable therapy parameters (power, treatment cell size, sonication depth) were investigated on a cell-by-cell basis to reflect tissue inhomogeneity. Two types of ablation efficacy indices (volume of 240 equivalent minutes at 43°C/treatment-cell volume, nonperfused volume/treatment-cell volume) were then correlated with those parameters using multiple linear regression analysis to determine which factors were significant predictors for ablation efficacy.
RESULTS:
: We used 293 treatment cells (4 mm, n = 12; 8 mm, n = 115; 12 mm, n = 149; 16 mm, n = 17), and all of them were analyzable. Ablation efficacies were 1.06 ± 0.58 and 0.67 ± 0.39. K (B = -12.035, P < 0.001 and B = -11.516, P < 0.001, respectively) among DCE-MRI parameters and acoustic power (B = 0.008, P < 0.001; B = 0.010, P < 0.001, respectively) among therapy parameters were revealed to be independently significant predictors for both types of ablation efficacy.
CONCLUSIONS:
: A higher K value at baseline DCE-MRI suggested a poor ablation efficacy of MR-HIFU therapy for symptomatic uterine fibroids."
