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Objective <p>To develop a pre-percutaneous microwave ablation (PMWA) model combining conventional ultrasound (CUS) and contrast-enhanced ultrasound (CEUS) for predicting non-perfused volume ratio (NPVR) ≥ 80% in patients with uterine fibroids.</p> Methods <p>This multicentre, retrospective study enrolled 276 patients with pathologically confirmed uterine fibroids (training/validation = 140/136). CUS features (maximum diameter, pre-operative volume, location, echo), CEUS parameters (maximum intensity: IMAX), and ablation parameters (energy, time, energy per unit volume [EPV], and time per unit volume [TPV]) were analysed. Multivariate logistic regression identified predictors, and model performance was assessed using the area under the receiver operating characteristic curve (AUC) and clinical decision curve analysis.</p> Results <p>Multivariate analysis identified four independent predictors: maximum diameter (odds ratio [OR] = 0.47, <i>p</i> &lt; 0.001), IMAX (OR = 0.34, <i>p</i> = 0.013), energy (OR = 1.01, <i>p</i> = 0.002), and TPV (OR = 0.69, <i>p</i> &lt; 0.001).&#xa0;The prediction model performed well in both the training (AUC = 0.79, 95% confidence interval [CI] = 0.71–0.87) and validation (AUC = 0.70, 95%CI = 0.61–0.79) datasets. <i>P</i> values for the Hosmer–Lemeshow test were 0.263 and 0.980, respectively, and the Brier Score was 0.184.</p> Conclusion <p>This study established a prediction model based on CUS features, CEUS perfusion parameters, and ablation parameters to evaluate the efficacy of PMWA for uterine fibroids; NPVR ≥ 80% can be predicted using the nomogram. This model enables accurate prediction of the efficacy of PMWA for uterine fibroids, providing profound guidance for pre-operative assessment and intraoperative management in clinical practice and facilitating personalised, precision treatment.</p>

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A predictive model combining conventional and contrast-enhanced ultrasound for predicting complete microwave ablation of uterine fibroids: a multi-centre study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月19日

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  • Yuqing Huang,
  • Yahui Ma,
  • Yufeng Wang,
  • Bin Wang,
  • Ya Sun,
  • Nan Zhou,
  • Xuedi Han,
  • Ruyue Tian,
  • Xin Zhang,
  • Yankun Zhao,
  • Xiaohong Sun,
  • Hao Yu,
  • Yandong Deng,
  • Lei Liang

摘要

Objective

To develop a pre-percutaneous microwave ablation (PMWA) model combining conventional ultrasound (CUS) and contrast-enhanced ultrasound (CEUS) for predicting non-perfused volume ratio (NPVR) ≥ 80% in patients with uterine fibroids.

Methods

This multicentre, retrospective study enrolled 276 patients with pathologically confirmed uterine fibroids (training/validation = 140/136). CUS features (maximum diameter, pre-operative volume, location, echo), CEUS parameters (maximum intensity: IMAX), and ablation parameters (energy, time, energy per unit volume [EPV], and time per unit volume [TPV]) were analysed. Multivariate logistic regression identified predictors, and model performance was assessed using the area under the receiver operating characteristic curve (AUC) and clinical decision curve analysis.

Results

Multivariate analysis identified four independent predictors: maximum diameter (odds ratio [OR] = 0.47, p < 0.001), IMAX (OR = 0.34, p = 0.013), energy (OR = 1.01, p = 0.002), and TPV (OR = 0.69, p < 0.001). The prediction model performed well in both the training (AUC = 0.79, 95% confidence interval [CI] = 0.71–0.87) and validation (AUC = 0.70, 95%CI = 0.61–0.79) datasets. P values for the Hosmer–Lemeshow test were 0.263 and 0.980, respectively, and the Brier Score was 0.184.

Conclusion

This study established a prediction model based on CUS features, CEUS perfusion parameters, and ablation parameters to evaluate the efficacy of PMWA for uterine fibroids; NPVR ≥ 80% can be predicted using the nomogram. This model enables accurate prediction of the efficacy of PMWA for uterine fibroids, providing profound guidance for pre-operative assessment and intraoperative management in clinical practice and facilitating personalised, precision treatment.