Volume transfer constant (Ktrans) maps from dynamic contrast enhanced MRI as potential guidance for MR-guided high intensity focused ultrasound treatment of hypervascular uterine fibroids

Liu, Jing; Keserci, Bilgin; Yang, Xuedong; Wei, Juan; Rong, Rong; Zhu, Ying; Wang, Xiaoying

doi:10.1016/j.mri.2014.05.005

Cited by 14 publications

(11 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although such heterogeneity may prevent signal‐intensity‐based classification of fibroids, it may also prove to be useful in planning MRgHIFU‐based fibroid treatment or in predicting treatment response. For example, Liu et al reported that in regions with high perfusion, as indicated by elevated K trans , higher acoustic power was required for MRgHIFU to confer effective treatment, and Kim et al reported that ablation efficiency was poor in fibroids with high K trans . Using traditional DCE‐MRI methods to obtain perfusion‐related metrics, such as K trans , requires the use of contrast agents.…”

Section: Discussionmentioning

confidence: 99%

Tissue characterization of uterine fibroids with an intravoxel incoherent motion model: The need for T₂ correction

Hor

Fischer

et al. 2018

Magnetic Resonance Imaging

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Tissue characterization of uterine fibroids with an intravoxel incoherent motion model: The need for T₂ correction

Hor

Fischer

et al. 2018

Magnetic Resonance Imaging

View full text Add to dashboard Cite

show abstract

“…Tissue perfusion in uterine fibroids has been identified as an important factor in determining the outcome of magnetic resonance (MR)‐guided high‐intensity focused ultrasound ablation and previous studies have identified that the effective ablation of hyper‐vascular tissue inside fibroids could significantly impact on treatment outcomes. The aim of the present study was to explore if ablation outcomes were affected by fibroids being either hypo‐ or hyper‐vascular.…”

Section: Fibroid‐ablation Outcomesmentioning

confidence: 99%

Effect of the degree of magnetic resonance‐guided high‐intensity focused ultrasound ablation of uterine fibroid tissue on 6‐month volume reduction

Liu

Keserci²,

Rong

et al. 2017

Intl J Gynecology & Obste

Self Cite

View full text Add to dashboard Cite

Dynamic contrast enhanced; Hyper-vascular fibroids; Magnetic resonance-guided high-intensity focused ultrasound ablation; Uterine fibroids Tissue perfusion in uterine fibroids has been identified as an important factor in determining the outcome of magnetic resonance (MR)-guided high-intensity focused ultrasound ablation and previous studies 1-4 have identified that the effective ablation of hyper-vascular tissue inside fibroids could significantly impact on treatment outcomes. The aim of the present study was to explore if ablation outcomes were affected by fibroids being either hypo-or hyper-vascular. The present retrospective study included data from 53 patients (mean age 43.6 years [range 30-51 years]) with 67 fibroids (mean maximum diameter 5.7 cm [range 3.2-10.4 cm], mean volume 161.2 cm 3 [range 29.7-698.9 cm 3 ]) who underwent successful MR-guided highintensity focused ultrasound ablation using a 3.0-T MR system (Philips, Best, the Netherlands) at Peking Universtiy First Hospital, Beijing, China. All participants underwent MR scanning to assess fibroid volume at baseline before ablation and at 6-month follow-up. All fibroids were classified into two groups at baseline according to dynamic contrast-enhanced MR images: a hyper-vascular fibroid group (defined by homogenous enhancement occurring at or above the uterine layer or more than 50% of a heterogeneously enhanced region being above the uterine layer) and a hypo-vascular fibroid group (defined by T A B L E 1 Fibroid-ablation outcomes. a

show abstract

“…Magnetic resonance (MR)-guided high-intensity focused ultrasound (HIFU) is applied widely in the ablation of symptomatic uterine fibroids [1][2][3][4]. Contrast-enhanced T1-weighted imaging (CE-T1WI) has been used in the assessment of the ablated areas of uterine fibroid, called the non-perfused volume (NPV), immediately following HIFU ablation and during follow-up.…”

mentioning

confidence: 99%

“…The patient had a prior cesarean delivery and thus, it is conjectured that the postoperative scarring created a uterine breach into which the placenta could opportunistically penetrate [4].…”

mentioning

confidence: 99%

See 1 more Smart Citation

T2*‐weighted imaging in the assessment of the non‐perfused volume of uterine fibroids following magnetic resonance‐guided high‐intensity focused ultrasound ablation

Liu

Wei

Keserci³

et al. 2015

Intl J Gynecology & Obste

Self Cite

View full text Add to dashboard Cite

Keywords:Fast field echo (FFE) T2*-weighted imaging (T2*WI) contrast-enhanced T1-weighted imaging (CE-T1WI) magnetic resonance-guided high-intensity focused ultrasound (HIFU) non-perfused volume (NPV) uterine fibroid Magnetic resonance (MR)-guided high-intensity focused ultrasound (HIFU) is applied widely in the ablation of symptomatic uterine fibroids [1-4]. Contrast-enhanced T1-weighted imaging (CE-T1WI) has been used in the assessment of the ablated areas of uterine fibroid, called the non-perfused volume (NPV), immediately following HIFU ablation and during follow-up. The present study details a case employing fast field echo T2*-weighted imaging (T2*WI) without the use of contrast agent for assessing NPV of fibroids in response to HIFU therapy, making a comparison with CE-T1WI. To our knowledge, this is the first report of this nature. A 45-year-old woman presenting with abdominal pain with uterine fibroids was treated by HIFU ablation. MR scanning and HIFU therapy were conducted using an Achieva TX 3 T MR scanner (Philips Healthcare, Best, The Netherlands). T2*WI (repetition time/echo time: 837/24 ms; slice thickness: 5 mm with a 1-mm gap; field of view: 240 × 240 mm; matrix: 320 × 250; flip angle: 24°) and CE-T1WI techniques were applied before and 3 minutes after the injection of contrast agents, respectively. The geometric parameters of T2*WI and CE T1WI were the same, including the scanning location and number of slices. T2*WI and CE-T1WI were compared slice by slice at the same location in the patient. The images produced using T2*WI had a high image quality and the NPV inside uterine fibroids could be visualized with clear margins on each slice, both during ablation and during follow-up. The majority of the NPV margins were irregular, but the details around the margins were almost exactly the same when employing T2*WI as CE-T1WI (Fig. 1). Using T2*WI, a dark-line around the NPV margin can be seen clearly; this might be due to surrounding micro hemorrhage. This appearance seems to make the boundary between NPV and fibroid tissue clearer with T2*WI in comparison with CE-T1WI. Additionally, two radiologists were asked to independently calculate the NPV areas on each slice from both T2*WI and CE-T1WI of the fibroids, with a paired t-test used to analyze the results; a P value of b0.05 was considered statistically significant. The statistical analysis showed no significant differences in the radiologists' calculated NPVs between T2*WI and CE-T1WI of the fibroids (first fibroid: t 1 = -1.063, P 1 = 0.296; second fibroid: t 2 = 0.375, P 2 = 0.714). The present case demonstrated the feasibility of T2*WI in the assessment of the ablated volume of fibroids treated with HIFU. As an alternative to CE-T1WI, T2*WI without the use of a contrast agent might be a very promising method in assessing NPV inside uterine fibroids following HIFU ablation, both in real-time and during follow-up after the procedure.

show abstract

Volume transfer constant (Ktrans) maps from dynamic contrast enhanced MRI as potential guidance for MR-guided high intensity focused ultrasound treatment of hypervascular uterine fibroids

Cited by 14 publications

References 16 publications

Tissue characterization of uterine fibroids with an intravoxel incoherent motion model: The need for T₂ correction

Tissue characterization of uterine fibroids with an intravoxel incoherent motion model: The need for T₂ correction

Effect of the degree of magnetic resonance‐guided high‐intensity focused ultrasound ablation of uterine fibroid tissue on 6‐month volume reduction

T2*‐weighted imaging in the assessment of the non‐perfused volume of uterine fibroids following magnetic resonance‐guided high‐intensity focused ultrasound ablation

Contact Info

Product

Resources

About

Volume transfer constant (Ktrans) maps from dynamic contrast enhanced MRI as potential guidance for MR-guided high intensity focused ultrasound treatment of hypervascular uterine fibroids

Cited by 14 publications

References 16 publications

Tissue characterization of uterine fibroids with an intravoxel incoherent motion model: The need for T2 correction

Tissue characterization of uterine fibroids with an intravoxel incoherent motion model: The need for T2 correction

Effect of the degree of magnetic resonance‐guided high‐intensity focused ultrasound ablation of uterine fibroid tissue on 6‐month volume reduction

T2*‐weighted imaging in the assessment of the non‐perfused volume of uterine fibroids following magnetic resonance‐guided high‐intensity focused ultrasound ablation

Contact Info

Product

Resources

About

Tissue characterization of uterine fibroids with an intravoxel incoherent motion model: The need for T₂ correction

Tissue characterization of uterine fibroids with an intravoxel incoherent motion model: The need for T₂ correction