ABSTRACT
Objective To investigate the value of whole-tumor histogram analysis of quantitative perfusion in the prediction of ablation response in MR-guided high-intensity focused ultrasound (MR-HIFU)treatment for uterine fibroids.Methods A total of 31 fibroids in 28 eligible patients were treated with MR-HIFU.Four histogram parameters of the quantitative perfusion parameter (Ktrans )were obtained prior to MR-HIFU treatment:mean,median,skewness and kurtosis.T1 contrast-enhanced MRI immediately after MR-HIFU was performed to determine the non-perfused volume (NPV)and acquire non-perfused volume ratio (NPVR).The relationship between NPVR and all fibroid characteristics was determined by Spearman correlation analysis.Results The 3 1 fibroids were divided into high-response group and low-response group according to whether NPVR was higher than 60%.Four histogram metrics of Ktrans showed statistical difference between the two groups.The mean and median of Ktrans ,fibroid maximum diameter and T2 signal intensity type were correlated with NPVR.The Spearman correlation coefficient were －0.60,－0.66,－0.45 and －0.39,respectively (P＜0.05).Conclusion Uterine fibroids with lower whole-tumor Ktrans can achieve higher immediate ablation efficiency in MR-HIFU.Together with its histogram metrics,it might be a valuable indicator for patient selecting.