Comparison of the diagnostic accuracy of contrast-enhanced MRI and diffusion-weighted MRI in the differentiation between uterine leiomyosarcoma / smooth muscle tumor with uncertain malignant potential and benign leiomyoma

Purpose To compare the diagnostic accuracy of contrast‐enhanced (CE) magnetic resonance imaging (MRI) and diffusion‐weighted MRI (DWI) in the differentiation between uterine leiomyosarcoma (LMS) / smooth muscle tumor with uncertain malignant potential (STUMP) and benign leiomyoma. Materials and Meth...

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Published in:Journal of magnetic resonance imaging 2016-02, Vol.43 (2), p.333-342
Main Authors: Lin, Gigin, Yang, Lan-Yan, Huang, Yu-Ting, Ng, Koon-Kwan, Ng, Shu-Hang, Ueng, Shir-Hwa, Chao, Angel, Yen, Tzu-Chen, Chang, Ting-Chang, Lai, Chyong-Huey
Format: Article
Language:English
Subjects:
Adult
contrast enhancement
Contrast Media
Diagnosis, Differential
diagnostic accuracy
Diffusion Magnetic Resonance Imaging
diffusion-weighted imaging
Female
Humans
Image Enhancement
Image Interpretation, Computer-Assisted
Leiomyoma - pathology
Leiomyosarcoma - pathology
Magnetic Resonance Imaging
Middle Aged
Prospective Studies
Reproducibility of Results
Sensitivity and Specificity
Smooth Muscle Tumor - pathology
Uterine Neoplasms - pathology
uterine sarcoma
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Summary:Purpose To compare the diagnostic accuracy of contrast‐enhanced (CE) magnetic resonance imaging (MRI) and diffusion‐weighted MRI (DWI) in the differentiation between uterine leiomyosarcoma (LMS) / smooth muscle tumor with uncertain malignant potential (STUMP) and benign leiomyoma. Materials and Methods A consecutive cohort of 8 LMS/STUMP and 25 benign leiomyomas underwent pelvic MRI exam at 3T. Two radiologists independently evaluated images based on CE‐MRI (central nonenhancement at equilibrial phase) and DWI (hyperintensity on b = 1000 s/mm2 and hypointensity on apparent diffusion coefficients [ADC] map). The ADC values were calculated from b = 0 and 1000 s/mm2. Results CE‐MRI yielded a significantly superior diagnostic accuracy (0.94 vs. 0.52) and a significantly higher specificity (0.96 vs. 0.36) than DWI (P < 0.05 for both), and remained a comparably high sensitivity as DWI (0.88 vs. 1.00). A combination of DWI and ADC value
ISSN:1053-1807
1522-2586
DOI:10.1002/jmri.24998