ORIGINAL RESEARCH article
Front. Med.
Sec. Obstetrics and Gynecology
Predictors of ≥50% Volume Reduction after Radiofrequency Ablation of Uterine Fibroids: A Single-Center Retrospective Case Series in Romania
Department of Obstetrics and Gynecology, Spitalul Pelican, Oradea, Romania
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Abstract
Study Objective To explore the potential of routinely collected pre procedural clinical and ultrasonographic parameters (age, classification, baseline fibroid volume, and baseline Doppler score) in relation to treatment response following transvaginal radiofrequency ablation (RFA), using a combined machine learning–based feature ranking and regression-based interpretability approach, and to provide a proof-of-concept for future data-driven predictive models. Design: Single-center retrospective case series. Setting: A public hospital in Romania where RFA was introduced as a minimally invasive alternative for uterine fibroid treatment. Patients: A total of 22 fibroids treated in women aged 28 to 52 years (mean age 38), selected based on symptoms or documented fibroid growth. Interventions: Transvaginal ultrasound-guided radiofrequency ablation performed using the VIVA RF system. Baseline and post procedural measurements included fibroid size, volume, vascularity (Doppler score), and anatomical classification (FIGO). Measurements and Main Results: Fibroid volume decreased from a mean of 60.82 cm³ to 28.3 cm³ (−54.0%), and Doppler score decreased from 3.59 to 1.41 (−59.8%). An exploratory feature-based analysis using four pre procedural variables (age, FIGO classification, baseline fibroid volume, and baseline Doppler score) was performed as a proof-of-concept, highlighting the challenges of robust modeling in small cohorts. In multivariable logistic regression analysis, no statistically significant association was observed between treatment outcome and patient age or FIGO classification. Conclusion: This proof-of-concept study supports the potential of using routine pre-procedural data for predictive analytics in RFA. The successful outcomes in two submucosal fibroids (G0, G1) suggest RFA followed by hysteroscopic myomectomy is a viable two-step fertility-preserving approach. The limitations of the small sample size and class imbalance underscore the critical need for larger, prospective, multicentric cohorts to develop clinically valid minimally invasive models.
Summary
Keywords
Heavy menstrual bleeding, Hysteroscopy, Leyomiomas, minimally invasive gynecological techniques, Radiofrecuency ablation, Uterine fibroids
Received
21 September 2025
Accepted
16 February 2026
Copyright
© 2026 Suciu-Lazar and Sotoc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Viorel Aurel Suciu-Lazar
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