Abstract
OBJECTIVES: To evaluate the effectiveness of high-intensity focused ultrasound (HIFU) therapy for treating uterine fibroids by utilizing multi-sequence magnetic resonance imaging radiomic models. METHODS: One hundred and fifty patients in our hospital were randomly divided into a training cohort (n=120) and an internal test cohort (n=30), and forty-five patients from another hospital serving as an external test cohort. Radiomics features of uterine fibroids were extracted and selected based on preoperative T2-weighted imaging fat suppression(T2WI-FS)and contrast-enhanced T1WI(CE-T1WI)images, and logistic regression was used to develop the T2WI-FS, CE-T1WI, and combined T2WI-FS + CE-T1WI models, along with the radiomics-clinical model integrating radiomics features with imaging characteristics. The performance and clinical applicability of each model were assessed through receiver operating characteristic (ROC) curve, decision curve analysis (DCA), as well as Network Readiness Index (NRI) and Integrated Discrimination Index (IDI). RESULTS: The AUC values of the radiomics-clinical model and the T2WI-FS + CE-T1WI model were the highest. In the training cohort, the radiomics-clinical model showed higher AUC values than the T2WI-FS + CE-T1WI model, while in the internal and external testing cohorts, the AUC values of the T2WI-FS + CE-T1WI model were higher than that of the radiomics-clinical model. DCA further demonstrated that these two models achieved the greatest net benefit. NRI and IDI analyses suggested that the T2WI-FS + CE-T1WI model had higher clinical utility. CONCLUSIONS: Both the T2WI-FS + CE-T1WI model and the radiomics-clinical model demonstrate higher predictive value and larger net benefit compared to other models.