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- Title
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.
- 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
- Abstract
<bold>Purpose: </bold>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.<bold>Materials and Methods: </bold>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 .<bold>Results: </bold>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 <1.08 × 10(-3) mm2 /s (determined by receiver operating characteristic analysis) improved diagnostic accuracy, sensitivity, and specificity of DWI to 0.88, 0.88, and 0.88, respectively, by post-hoc analysis based on the same study cohort.<bold>Conclusion: </bold>For prospective differentiation between uterine LMS/STUMP and benign leiomyoma, CE-MRI can provide accurate information and is preferable to DWI. Combination of DWI and ADC values can achieve a comparable diagnostic accuracy to CE-MRI.
- Publication
Journal of Magnetic Resonance Imaging, 2016, Vol 43, Issue 2, p333
- ISSN
1053-1807
- Publication type
journal article
- DOI
10.1002/jmri.24998