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Differentiation of uterine low-grade endometrial stromal sarcoma from rare leiomyoma variants by magnetic resonance imaging
Description
<jats:title>Abstract</jats:title><jats:p>The purpose of this study is to evaluate utility of MRI in differentiation of uterine low-grade endometrial stromal sarcoma (LGESS) from rare leiomyoma variants. This multi-center retrospective study included consecutive 25 patients with uterine LGESS and 42 patients with rare leiomyoma variants who had pretreatment MRI. Two radiologists (R1/R2) independently evaluated MRI features, which were analyzed statistically using Fisher’s exact test or Student's <jats:italic>t</jats:italic>-test. Subsequently, using a five-point Likert scale, the two radiologists evaluated the diagnostic performance of a pre-defined MRI system using features reported as characteristics of LGESS in previous case series: uterine tumor with high signal intensity (SI) on diffusion-weighted images and with either worm-like nodular extension, intra-tumoral low SI bands, or low SI rim on T2-weighted images. Area under the receiver operating characteristic curve (AUC), sensitivity, and specificity of the two readers’ Likert scales were analyzed. Intra-tumoral low SI bands (<jats:italic>p</jats:italic> < 0.001), cystic/necrotic change (<jats:italic>p</jats:italic> ≤ 0.02), absence of speckled appearance (<jats:italic>p</jats:italic> < 0.001) on T2-weighted images, and a low apparent diffusion coefficient value (<jats:italic>p</jats:italic> ≤ 0.02) were significantly associated with LGESS. The pre-defined MRI system showed very good diagnostic performance: AUC 0.86/0.89, sensitivity 0.95/0.95, and specificity 0.67/0.69 for R1/R2. MRI can be useful to differentiate uterine LGESS from rare leiomyoma variants.</jats:p>
Journal
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- Scientific Reports
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Scientific Reports 11 (1), 2021-09-27
Springer Science and Business Media LLC
