Current concepts in the imaging of uterine sarcoma

Tirumani, Sree Harsha; Ojili, Vijayanadh; Shanbhogue, Krishna; Fasih, Najla; Ryan, John G.; Reinhold, Caroline

doi:10.1007/s00261-012-9919-x

Cited by 67 publications

(54 citation statements)

References 48 publications

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“…Bevacizumab can be combined with second-line regimens if it has not been used with the first-line regimen (35,36). Regorafenib has been shown in recent trials to have activity in metastatic colorectal cancer refractory to chemotherapeutic drugs and was approved by the FDA in 2012 (37,38).…”

Section: Antiangiogenic Mttsmentioning

confidence: 99%

Anti-VEGF Molecular Targeted Therapies in Common Solid Malignancies: Comprehensive Update for Radiologists

Tirumani

Fairchild²,

Krajewski³

et al. 2015

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Angiogenesis is an essential component of the growth and dissemination of solid malignancies and is mediated by several proangiogenic factors. The most widely studied proangiogenic factor is vascular endothelial growth factor (VEGF). A major class of molecular targeted therapies (MTTs) inhibit the VEGF axis and are referred to as antiangiogenic MTTs. There are two main types of anti-VEGF MTTs: drugs targeting circulating VEGF and drugs interfering with the activity of the VEGF receptors. The cancers against which antiangiogenic MTTs have had the greatest effect are gliomas, non-small cell lung cancer, colorectal cancer, hepatocellular carcinoma, renal cell carcinoma, and gastrointestinal stromal tumor. These cancers respond to antiangiogenic MTTs in a different way than they respond to conventional chemotherapy. Instead of the traditional Response Evaluation Criteria in Solid Tumors (RECIST), each of these cancers therefore requires its own individualized treatment response criteria (TRC). Examples of individualized TRC include the Response Assessment in Neuro-oncology (RANO) criteria for gliomas, modified RECIST for hepatocellular carcinoma, and Morphology, Attenuation, Size, and Structure (MASS) criteria for renal cell carcinoma. Furthermore, antiangiogenic MTTs have a unique spectrum of class-specific and drug-specific toxic effects, some of which can be detected at imaging. Increasing use of antiangiogenic MTTs in clinical practice necessitates that radiologists be aware of these drugs, their response patterns, and TRC as well as their toxic effect profiles.

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Section: Antiangiogenic Mttsmentioning

confidence: 99%

Anti-VEGF Molecular Targeted Therapies in Common Solid Malignancies: Comprehensive Update for Radiologists

Tirumani

Fairchild²,

Krajewski³

et al. 2015

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“…The same appearance is shown by cellular leiomyomas and some types of degenerated leiomyomas, which then may mime sarcomas. Therefore, the differential diagnosis between myoma and sarcoma can be difficult if it is just based on conventional sequences without administration of contrast agent [19][20][21] .…”

Section: Introductionmentioning

confidence: 99%

The contribution of Magnetic Resonance Imaging in the differential diagnosis between leiomyoma typical, atypical and uterine sarcomas: Personal experience

Tamburrini

Smiraglio

Caputo

et al. 2016

IJDI

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Purpose: Evaluate the role of Magnetic Resonance Imaging (MRI) in the differential diagnosis between degenerated leiomyomas, cellular leiomyomas and uterine sarcomas. Materials and methods:From February 2015 to August 2015, 42 patients were enrolled, aged between 18 and 75 years, suffering from uterine "mass" waiting for surgery and considered at risk and/or uncertain clinical and laboratory investigations and imaging. These patients were submitted to MRI exam of the pelvis that was performed by morphological study, DWI sequences and dynamic sequences post-contrastographic. Results:The analysis of MRI images of the 42 patients made possible to do a diagnosis of uterine sarcomas in 8 patients with the aid of sequences weighted in diffusion and dynamic, proving a sensitivity of 100% and a specificity of 88%. Conclusions:Based on our experience, we may consider that by morphological study with DWI sequences weighted in diffusion and dynamic post-contrastographic sequences, the MRI is a working aid in the differential diagnosis between degenerated leiomyomas and uterine sarcomas.

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“…In the specialized medical literature, approximately 50% of the uterine sarcomas are carcinosarcomas. 1,2,6,7 In our series, 61.5% of the cases were carcinosarcomas. Uterine sarcomas are generally diagnosed in postmenopausal women that go to the doctor due to metrorrhagias, whose form of presentation is similar to that of endometrial adenocarcinomas.…”

Section: Discussionmentioning

confidence: 86%

“…These results can be explained given the mixed and heterogeneous nature of these tumors. 2,3,7,18,19 The limitations of our study include its retrospective design, the small size of the sample and small variations in the MRI protocols during the period in which they were conducted (10 years). The low incidence of these tumors can justify how difficult it is to conduct a prospective study.…”

Section: Discussionmentioning

confidence: 98%

“…They have a different dissemination pattern and management than that of adenocarcinomas. 1,2,4 The treatment of choice continues to be the hysterectomy with bilateral adnexectomy, but given the high rate of local relapses and metastases, both the lymphanedectomy and adjuvant therapies are probably useful. There is no consensus in the clinical guidelines on its optimal therapeutic management.…”

Section: Introductionmentioning

confidence: 99%

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