Parisa Aminzadeh1, Ekaterina Alibrahim1, Andrew Dobrotwir1, Eldho Paul2, Stacy Goergen1,3,4. 1. Royal Women's Hospital, Parkville, Victoria, Australia. 2. Department of Epidemiology and Preventive Medicine, Monash University, Commercial Road, Prahran, Victoria, Australia. 3. Monash Imaging, Monash Health, Clayton, Victoria, Australia. 4. School of Clinical Sciences, Monash University, Clayton, Victoria, Australia.
Abstract
OBJECTIVE: To assess accuracy of and interobserver agreement on multiparametric MR findings to distinguish uterine leiomyoma (LM) from uterine leiomyosarcoma (LMS) and soft tissue tumour of unknown malignant potential. METHODS: Inclusion criteria: All females over 18 years with least one uterine mass measuring 5 cm or more in at least one of the three standard orthogonal dimensions on MR with histopathological confirmation of LM, LMS, or soft tissue tumour of unknown malignant potential (STUMP) in the 3 months following MR. Patients with LMS were drawn from a larger cohort being assessed for MR-guided focussed ultrasound (MRgFUS) suitability. Image evaluation: Assessed variables were: lesion margin, margin definition, T2 signal homogeneity, >50% of lesion with T2 signal brighter than myometrium, haemorrhage, restricted diffusion, contrast enhancement (CE), CE pattern, local lymphadenopathy and ascites. RESULTS: 32 LM, 10 LMS and 1 STUMP were evaluated. Ill-defined (p-value = 0.0003-0.0004) or irregular (p = 0.003-0.004) lesion margin, T2 hyperintensity >50% (p = 0.001-0.004), and peripheral CE (p = 0.02-0.05) were significantly more common in LMS/STUMP than LM for both radiologists. 10/11 (Reader 2) and 11/11 (Reader 1) LMS/STUMP displayed restricted diffusion but so did 63-80% of LM. Agreement was greatest for margin characteristics (κ = 0.73-0.81). CONCLUSION: Irregular/ill-defined lesion margin best distinguished LMS/STUMP from LM with good interrater reliability. ADVANCES IN KNOWLEDGE: Assessment of agreement regarding MR parameters distinguishing LM from LMS and STUMP has not previously been undertaken in a cohort including a large number of patients with LMS. This will help inform evaluation of females considering minimally invasive LM treatment.
OBJECTIVE: To assess accuracy of and interobserver agreement on multiparametric MR findings to distinguish uterine leiomyoma (LM) from uterine leiomyosarcoma (LMS) and soft tissue tumour of unknown malignant potential. METHODS: Inclusion criteria: All females over 18 years with least one uterine mass measuring 5 cm or more in at least one of the three standard orthogonal dimensions on MR with histopathological confirmation of LM, LMS, or soft tissue tumour of unknown malignant potential (STUMP) in the 3 months following MR. Patients with LMS were drawn from a larger cohort being assessed for MR-guided focussed ultrasound (MRgFUS) suitability. Image evaluation: Assessed variables were: lesion margin, margin definition, T2 signal homogeneity, >50% of lesion with T2 signal brighter than myometrium, haemorrhage, restricted diffusion, contrast enhancement (CE), CE pattern, local lymphadenopathy and ascites. RESULTS: 32 LM, 10 LMS and 1 STUMP were evaluated. Ill-defined (p-value = 0.0003-0.0004) or irregular (p = 0.003-0.004) lesion margin, T2 hyperintensity >50% (p = 0.001-0.004), and peripheral CE (p = 0.02-0.05) were significantly more common in LMS/STUMP than LM for both radiologists. 10/11 (Reader 2) and 11/11 (Reader 1) LMS/STUMP displayed restricted diffusion but so did 63-80% of LM. Agreement was greatest for margin characteristics (κ = 0.73-0.81). CONCLUSION: Irregular/ill-defined lesion margin best distinguished LMS/STUMP from LM with good interrater reliability. ADVANCES IN KNOWLEDGE: Assessment of agreement regarding MR parameters distinguishing LM from LMS and STUMP has not previously been undertaken in a cohort including a large number of patients with LMS. This will help inform evaluation of females considering minimally invasive LM treatment.
Authors: L Joseph Melton; Sara J Achenbach; John B Gebhart; Ebenezer O Babalola; Elizabeth J Atkinson; Adil E Bharucha Journal: Fertil Steril Date: 2007-01-30 Impact factor: 7.329
Authors: Gloria Ravegnini; Martina Ferioli; Maria Abbondanza Pantaleo; Alessio G Morganti; Antonio De Leo; Pierandrea De Iaco; Stefania Rizzo; Anna Myriam Perrone Journal: PLoS One Date: 2022-06-08 Impact factor: 3.752