Diagnostic value of 3 T MR spectroscopy, diffusion-weighted MRI, and apparent diffusion coefficient value for distinguishing benign from malignant myometrial tumours

Rahimifar, Pariya; Hashemi, Hassan; Malek, Mahrooz; Ebrahimi, Soheila; Tabibian, Elnaz; Alidoosti, Azadeh; Mousavi, Azam Sadat; Yarandi, Fariba

doi:10.1016/j.crad.2019.03.011

Cited by 15 publications

(21 citation statements)

References 39 publications

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“…The present study also found that the differences in the average values between the ESS and DH groups were statistically significant in the T2WI histogram parameters and the parameters in the ESS group were slightly larger. This indicates that the lesions in the ESS group had higher signal intensity in the imaging, which might correlate with the fact that an ESS tumor resembles proliferative endometrial interstitial cell components and contains abundant mucus components, and the literature consistently reports this (19). ESS has a rich blood supply and high microvessel density, showing obvious enhancement in the early stage and maintaining a high enhancement level in later stages.…”

Section: Discussionmentioning

confidence: 71%

The Value of Magnetic Resonance Imaging Histograms in the Preoperative Differential Diagnosis of Endometrial Stromal Sarcoma and Degenerative Hysteromyoma

Zhang

Bai

et al. 2021

Front. Surg.

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Objective: The present study aimed to explore the application value of magnetic resonance imaging (MRI) histograms with multiple sequences in the preoperative differential diagnosis of endometrial stromal sarcoma (ESS) and degenerative hysteromyoma (DH).Methods: The clinical and preoperative MRI data of 20 patients with pathologically confirmed ESS and 24 patients with pathologically confirmed DH were retrospectively analyzed, forming the two study groups. Mazda software was used to select the MRI layer with the largest tumor diameter in T2WI, the apparent diffusion coefficient (ADC), and enhanced T1WI (T1CE) images. The region of interest (ROI) was outlined for gray-scale histogram analysis. Nine parameters—the mean, variance, kurtosis, skewness, 1st percentile, 10th percentile, 50th percentile, 90th percentile, and 99th percentile—were obtained for intergroup analysis, and the receiver operating curves (ROCs) were plotted to analyze the differential diagnostic efficacy for each parameter.Results: In the T2WI histogram, the differences between the two groups in seven of the parameters (mean, skewness, 1st percentile, 10th percentile, 50th percentile, 90th percentile, and 99th percentile) were statistically significant (P < 0.05). In the ADC histogram, the differences between the two groups in three of the parameters (skewness, 10th percentile, and 50th percentile) were statistically significant (P < 0.05). In the T1CE histogram, no significant differences were found between the two groups in any of the parameters (all P > 0.05). Of the nine parameters, the 50th percentile was found to have the best diagnostic efficacy. In the T2WI histogram, ROC curve analysis of the 50th percentile yielded the best area under the ROC curve (AUC; 0.742), sensitivity of 70%, and specificity of 83.3%. In the ADC histogram, ROC curve analysis of the 50th percentile yielded the best area under the ROC curve (AUC; 0.783), sensitivity of 81%, and specificity of 76.9%.Conclusion: The parameters of the mean, 10th percentile and 50th percentile in the T2WI histogram have good diagnostic efficacy, providing new methods and ideas for clinical diagnosis.

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Section: Discussionmentioning

confidence: 71%

The Value of Magnetic Resonance Imaging Histograms in the Preoperative Differential Diagnosis of Endometrial Stromal Sarcoma and Degenerative Hysteromyoma

Zhang

Bai

et al. 2021

Front. Surg.

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“…Rahimifar et al [ 49 ] evaluated 1 H magnetic resonance spectroscopy (MRS), and compared and combined it with DWI to classify the tumors as malignant or benign. MRS detects markers of biochemical processes and can provide information on metabolism, transformation into malignant tissue, and presence of active tumors.…”

Section: Resultsmentioning

confidence: 99%

Sonographic and Magnetic Resonance Characteristics of Gynecological Sarcoma

et al. 2023

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Introduction: Gynecological sarcomas are rare malignant tumors with an incidence of 1.5–3/100,000 and are 3–9% of all malignant uterine tumors. The preoperative differentiation between sarcoma and myoma becomes increasingly important with the development of minimally invasive treatments for myomas, as this means undertreatment for sarcoma. There are currently no reliable laboratory tests or imaging-characteristics to detect sarcomas. The objective of this article is to gain an overview of sarcoma US/MRI characteristics and assess their accuracy for preoperative diagnosis. Methods: A systematic literature review was performed and 12 studies on ultrasound and 21 studies on MRI were included. Results: For the ultrasound, these key features were gathered: solid tumor > 8 cm, unsharp borders, heterogeneous echogenicity, no acoustic shadowing, rich vascularization, and cystic changes within. For the MRI, these key features were gathered: irregular borders; heterogeneous; high signal on T2WI intensity; and hemorrhagic and necrotic changes, with central non-enhancement, hyperintensity on DWI, and low values for ADC. Conclusions: These features are supported by the current literature. In retrospective analyses, the ultrasound did not show a sufficient accuracy for diagnosing sarcoma preoperatively and could also not differentiate between the different subtypes. The MRI showed mixed results: various studies achieved high sensitivities in their analysis, when combining multiple characteristics. Overall, these findings need further verification in prospective studies with larger study populations.

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“…In uterine pathology where benign masses might be mistaken with sarcoma, DTI could likely benefit from the superior SNR offered by UHF MRI. Interesting results regarding malignancy characteristics of a given lesion have been reported at 3T [60]. Machine learning might also benefit from technical advances in this field [61,62].…”

Section: Discussionmentioning

confidence: 99%

Are We Heading to the Future of Musculoskeletal Tumor Imaging with Ultra-High Field 7T MRI?

Fouré¹,

Rochwerger²,

Troter³

et al. 2020

COR

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Background and objectives: Sarcoma preoperative planning critically depends on MRI, sometimes uninformative when compartments barriers or critical structures are involved. objective: to prospectively assess the feasibility and the potential of 7T MRI in sarcoma. Methods: Two patients with femoral chondrosarcoma were CT and MRI (1.5 and 7T) scanned with T1W, T2W, GRE and DTI sequences. Image quality and characteristics of the tumors were compared between these modalities. Results: In-plane resolution was higher at 7T as compared to 1.5T MRI, tumor delineation was more reliable and soft tissue involvement was clearer. DT imaging and corresponding ADC mapping allowed a clear distinction between edema and tumor and identified tumor involvement of collateral ligament allowing healthy structures sparing with histopathology confirmation. 7T MRI was also able to define cortical reaction as precisely as CT imaging. Conclusion: Musculoskeletal tumours UHF-MRI is promising. Higher resolution and enhanced signal to noise ratio improved tumoral assessment, infiltration and cortex changes. One could expect this nonradiating technique to replace CT investigation for bone tumours assessment and open new perspectives in the fields of vascular or nerve salvage and response to chemo/radiotherapy. Healthy tissue sparing might be facilitated with impacts on function, complication or reconstruction type.

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Diagnostic value of 3 T MR spectroscopy, diffusion-weighted MRI, and apparent diffusion coefficient value for distinguishing benign from malignant myometrial tumours

Cited by 15 publications

References 39 publications

The Value of Magnetic Resonance Imaging Histograms in the Preoperative Differential Diagnosis of Endometrial Stromal Sarcoma and Degenerative Hysteromyoma

The Value of Magnetic Resonance Imaging Histograms in the Preoperative Differential Diagnosis of Endometrial Stromal Sarcoma and Degenerative Hysteromyoma

Sonographic and Magnetic Resonance Characteristics of Gynecological Sarcoma

Are We Heading to the Future of Musculoskeletal Tumor Imaging with Ultra-High Field 7T MRI?

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