ORIGINAL RESEARCH article
Front. Oncol.
Sec. Cancer Imaging and Image-directed Interventions
Intratumoral and peritumoral radiomics for preoperative prediction of the efficacy of HIFU Ablation for Uterine Fibroids Based on Multiparametric MRI: A Multicenter Study
Provisionally accepted
- Department of Radiology, The Third People's Hospital of Chengdu, Chengdu, China
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Objectives: To assess the predictive value of intratumoral and multiregion peritumoral radiomics based on multiparametric MRI for preoperatively predicting the efficacy of high-intensity focused ultrasound (HIFU) ablation of uterine fibroids. Materials and Methods: This retrospective study included 360 patients with uterine fibroids treated with high-intensity focused ultrasound (HIFU) at Center A (training set: N = 240; internal testing set: N = 60) and Center B (external testing set: N = 60). Patients were grouped into sufficient or insufficient ablation categories based on postoperative non-perfusion volume ratio. Intratumoral regions (TRs) were manually delineated on T2-weighted imaging (T2WI) and contrast-enhanced T1-weighted imaging (CE-T1WI). Peritumoral regions (PTRs) were generated by expanding the tumor boundary by 1 mm, 3 mm, and 5 mm. Radiomics features were extracted from TRs and PTRs on both MRI sequences. Key features for preoperative prediction were selected using t-tests, Pearson correlation, and LASSO regression. Support vector machine (SVM) models were built for TRs from T2WI and CE-T1WI, and for combined intratumoral and peritumoral regions (T-PTRs). A fusion model integrated optimal T-PTRs features from both sequences. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC). Results: The T-PTRs radiomics models outperformed the TR models, with the T-PTRs (3 mm) model demonstrating optimal performance. The integration of T2WI and CE-T1WI further enhanced the T-PTRs model, yielding an AUC of 0.892(0.814-0.969) on the internal test set and an AUC of 0.828(0.741 - 0.915) on the external validation set. Conclusion: The predictive model based on intratumoral and peritumoral radiomics features serves as a valuable tool for predicting the therapeutic efficacy of HIFU ablation of uterine fibroids.
Keywords: efficacy prediction, High-intensity focused ultrasound, Magnetic Resonance Imaging, Radiomics, Uterine fibroids
Received: 08 Sep 2025; Accepted: 16 Dec 2025.
Copyright: © 2025 Gao, Li, Liao and Liu. 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: Jin Gao
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