Development and validation of a combined model based on dual-sequence MRI radiomics for predicting the efficacy of high-intensity focused ultrasound ablation for hysteromyoma.

OBJECTIVES: To determine the value of dual-sequence magnetic resonance imaging (MRI)-based radiomics in predicting the efficacy of high-intensity focused ultrasound (HIFU) ablation for hysteromyoma. METHODS: A total of 142 patients with 172 hysteromyomas (95 hysteromyomas from the sufficient ablation group, and 77 hysteromyomas from the insufficient ablation group) were enrolled in the study. The clinical-radiological model was constructed with independent clinical-radiological risk factors, the radiomics model was constructed based on the optimal radiomics features of hysteromyoma from dual sequences, and the two groups of features were incorporated to construct the combined model. A fivefold cross validation procedure was adopted to validate these models. A nomogram was constructed, applying the combined model in the training cohort. The models were assessed with receiver operating characteristic (ROC) curves and integrated discrimination improvement (IDI). An independent test cohort comprising 40 patients was used to evaluate the performance of the optimal model. RESULTS: Among the three models, the average areas under the ROC curves (AUC) of the radiomics model and combined model were 0.803 (95% confidence interval (CI): 0.726-0.881) and 0.841 (95% CI: 0.772-0.909), which were better than the clinical-radiological model in the training cohort. The IDI showed that the combined model had the best prediction accuracy. The combined model also showed good discrimination in both the validation cohort (AUC = 0.834) and the independent test cohort (AUC = 0.801). CONCLUSION: The combined model based on the dual-sequence MRI radiomics is the most promising tool from our study to assist clinicians in predicting HIFU ablation efficacy.