Comparison of the diagnostic accuracy of contrast-enhanced/DWI MRI and ultrasonography in the differentiation between benign and malignant myometrial tumors. (October 2021)

• Record Type: Journal Article
• Authors: Najibi, Shaparak; Gilani, Mitra Modares; Zamani, Fatemeh; Akhavan, Setare; Zamani, Narges
• Is Part Of: Annals of medicine and surgery. Volume 70(2021)
• Publication Date: 2021-10
• Subjects: Malignant myometrial tumors -- MRI -- Ultrasonography -- Cross sectional -- Diagnostic value -- Test accuracy; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2021.102813
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Background: Various modalities including ultrasonography and magnetic resonance imaging (MRI) have been developed as imaging technique for screening malignant myometrial tumors, but a few studies assessed the diagnostic value of these two techniques in differentiation of benign from malignant myometrial tumors that had been the main purpose of this study. Materials and methods: This cross-sectional study was performed on 63 women underwent surgery for intrauterine masses that were initially assessed using MRI and ultrasound before surgery at a tertiary hospital in Tehran from 2016 to 2020. Their MRI was reviewed by a reputable radiologist in the field. The findings of histopathological assessment were considered as the gold diagnostic standard. Results: The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of MRI to detect sarcoma were revealed to be 94.6%, 92.3%, 94.6%, 92.3%, and 93.7% respectively. Ultrasonography had not preferable applicability to differentiate sarcoma from benign tumors with sensitivity, specificity, PPV, NPV and accuracy of 35.1%, 88.4%, 81.2%, 48.9%, and 57.1% respectively. The diagnostic performance of both modalities was not affected by baseline clinical conditions including pain, abnormal uterine bleeding and menopausal status. Conclusion: MRI but not ultrasonography can effectively differentiate benign from malignant myometrial tumors. Highlights: Pretreatment Diagnosis of malignant myometrial tumors may be challenging. MRI with DWI can be considered as a diagnostic tool in leiomyosarcoma. Pretreatment distinction between benign and malignant myometrial tumors is necessary.