Predicting Clinical Outcomes and Symptom Relief in Uterine Fibroid Embolization Using Machine Learning on MRI Features

Sepehr Janghorbani, Alexandre Caprio, Laya Sam, Benjamin C. Lee, Mert R. Sabuncu, Nicole A. Lamparello, Marc Schiffman, Bobak Mosadegh

Uterine fibroids are one of the leading health concerns for women worldwide, affecting up to 80% of women by the age of 50. While recent advancements have improved the diagnosis and treatment of fibroids, the current standard of care still faces important limitations due to the need for a personalized approach to treatment. Uterine fibroid embolization (UFE) has emerged as a promising minimally invasive alternative to traditional surgery, offering advantages such as shorter recovery times, fewer complications, and the preservation of the uterus. However, despite their highly reported effectiveness, only about 1% of eligible patients are offered UFE. This drastic underutilization is partially due to limited physician confidence in predicting patient-specific outcomes. To address this challenge, in this study, we aim to present an objective analysis of the factors influencing UFE success and introduce a scalable and interpretable machine learning (ML) system designed to support clinical decision-making. We have curated a dataset that includes 74 patients, with a total of 311 fibroids for our analysis. We have also developed two sets of ML models for predicting UFE procedure success based on a pre-operative MRI scan as the input. The first model predicts overall procedure success and the likelihood of relieving specific symptoms, achieving an accuracy of 75% (AUC = 0.74) for procedure outcome and 81–88% (AUC = 0.81–0.87) for different symptoms, respectively. The second set of models predicts the success of each individual fibroid responding to the treatment, achieving a 76% accuracy and 75% F-1 score. The AI models in this study can potentially provide patient-specific prediction of procedure effectiveness on both patient-level and fibroid-level, enhancing procedure referral accuracy.