Value of a combined magnetic resonance-enhanced and diffusion-weighted imaging dual-sequence radiomics model in predicting the efficacy of high-intensity focused ultrasound ablation for uterine fibroids.

Objective: To establish a joint radiomics model based on T1 contrast-enhanced (T1C) imaging and diffusion-weighted imaging (DWI), and investigate its value in predicting the efficacy of high-intensity focused ultrasound (HIFU) in ablating uterine fibroids.

Methods: This multicenter retrospective study included 195 patients with uterine fibroids. Their data were divided into training (n = 120), internal test (n = 30), and external test (n = 45) sets. The radiomic features were extracted from T1C and DWI sequences. Logistic regression was used to develop the T1C, DWI, integration, and joint models, and receiver operating characteristic curves were used to assess model performance. The Delong test was used to compare the predictive efficacies of different models, and the best model was used for external validation and development of the nomogram.

Results: Eight T1C features, six DWI features, and three imaging features were retained for the modeling. The areas under the curve were 0.852 and 0.769 for the integrated model on the training and internal test sets, respectively; 0.857 and 0.824 for the joint model on the training and internal test sets, respectively, which were higher than those of the single-sequence model; and 0.857 for the joint model on the external test set.

Conclusions: A joint radiomics model based on T1C and DWI data can effectively predict the efficacy of HIFU for ablating uterine fibroids and guide the development of individualized clinical treatment plans.