Journal of Clinical Gynecology and Obstetrics, ISSN 1927-1271 print, 1927-128X online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Gynecol Obstet and Elmer Press Inc
Journal website https://jcgo.elmerpub.com

Original Article

Volume 000, Number 000, March 2025, pages 000-000

Magnetic Resonance Imaging-Based Prediction of Uterine Fibroid Size Reduction by Relugolix Using T2-Weighted Signal Intensity Ratio: A Retrospective Multicenter Study

Figures

Figure 1.
Figure 1. Region of interest (ROI) setting in T2-weighted images. In the T2-weighted image of this case, the ROI of the uterine fibroid was set in the area surrounded by the green line. We selected a site that contained as large an ellipse as possible without including cystic or necrotic areas with high signal intensity. The ROI was set for the iliac muscle in the same way (the area surrounded by the purple line).
Figure 2.
Figure 2. Patients and uterine fibroids selection criteria.
Figure 3.
Figure 3. Boxplot comparing T2WI ratio by dividing uterine fibroid volume reduction rate by 50%. T2WI ratio is significantly larger in the group with a volume reduction of ≥ 50% compared to the group with a volume reduction of < 50% (P = 0.006). T2WI: T2-weighted image.
Figure 4.
Figure 4. Receiver operating characteristic curve created by assuming that a fibroid volume reduction rate of 50% or more is effective (positive). The cut-off value was 1.751 and the area under the curve was 0.772 (95% CI, 0.598 - 0.945). CI: confidence interval.
Figure 5.
Figure 5. Spearman’s rank correlation coefficient determined for two continuous variables: the T2WI ratio and the rate of uterine fibroid volume reduction. T2WI: T2-weighted image.

Tables

Table 1. Characteristics of Uterine Fibroids Divided by Volume Reduction Rate of 50%
 
< 50%≥ 50%P
BMI: body mass index; IQR: interquartile range.
Number of uterine fibroids619-
Age, median (IQR)44.0 (38.0 - 46.0)44.0 (41.0 - 45.0)0.469
BMI, median (IQR)23.0 (21.8 - 25.9)22.6 (21.6 - 25.4)0.586
Gravidity, median (IQR)1.0 (0 - 2.0)2.0 (0 - 2.0)0.844
Parity, median (IQR)1.0 (0 - 2.0)2.0 (0 - 2.0)0.400
Number of days of relugolix administration, median (IQR)92.0 (84.0 - 112.0)101.0 (91.0 - 118.0)0.272

 

Table 2. Evaluation of Test Accuracy When T2-Weighted Image Ratio Cutoff Value Is Set to 1.751
 
≥ 50%< 50%
T2WI: T2-weighted image.
T2WI ratio ≥ 1.751922
T2WI ratio < 1.751138
Sensitivity0.900
Specificity0.633
Positive predictive value0.290
Negative predictive value0.97