Differential Diagnosis of Uterine Leiomyoma and Uterine Sarcoma Using Magnetic Resonance Images: A Literature Review

Suzuki, Ayako; Aoki, Masato; Miyagawa, Chiho; Murakami, Kosuke; Takaya, Hisamitsu; Kotani, Yoshihisa; Matsumura, Noriomi

doi:10.3390/healthcare7040158

Cited by 34 publications

(33 citation statements)

References 25 publications

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“…Differences in plasma metabolites levels, especially in patients with large leiomyomas, leads to some inferences and comparisons with oncological conditions. There is a current and persistent search for an early diagnostic method for uterine sarcoma [ 53 ]. Yet, to date, there are no studies in the literature correlating metabolomic and uterine sarcomas.…”

Section: Discussionmentioning

confidence: 99%

Metabolomic Profiling of Peripheral Plasma by GC-MS and Correlation With Size of Uterine Leiomyomas

Barison

Izidoro²,

D’Amora

et al. 2022

Journal of the Endocrine Society

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BACKGROUND Uterine leiomyomas are benign monoclonal tumors originating from the myometrium. Little information exists concerning metabolomics and the presence of leiomyomas. OBJECTIVE The present study evaluated circulating metabolites in the plasma, aiming to correlate with presence and size of leiomyomas. STUDY DESIGN Cross-sectional observational study, including women divided into three groups: 37 with leiomyomas and uterus over 500 cm 3, 17 with leiomyomas and uterus up to 150 cm 3, and 21 leiomyoma-free. Patients underwent peripheral blood collection using untargeted metabolic assessment by gas chromatography coupled to mass spectrometer. RESULTS There was no statistical difference between patients’ anthropometric and demographic features and laboratory tests. Statistical differences in uterus volume (p<0.0001) were found. Forty-six metabolites were identified (35% were amino acids and derivatives, 22% fatty acids and 18% carbohydrates). Statistically significant metabolic distinction (p<0.05 and FDR<0.05) was observed for 14 metabolites. Most amino acids (L-isoleucine, L-valine and pyroglutamic acid) were significantly reduced in plasma levels of patients with large leiomyomas. The only exception was L-glutamine, with a significant increase. Fatty acids (arachidonic acid, alfa-tocopherol, palmitic acid and stearic acid) were similarly reduced in large leiomyomas patients, except for alpha-linolenic acid, which increased. For carbohydrates (myo-inositol, D-threitol and D-ribose) there was a decrease in the plasma of patients with leiomyomas. CONCLUSION There are different plasma metabolites levels of amino acids, fatty acids, and carbohydrates among patients with leiomyomas, most of them reduced and significantly more in large leiomyomas compared to leiomyoma-free patients.

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Section: Discussionmentioning

confidence: 99%

Metabolomic Profiling of Peripheral Plasma by GC-MS and Correlation With Size of Uterine Leiomyomas

Barison

Izidoro²,

D’Amora

et al. 2022

Journal of the Endocrine Society

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“…All women scheduled to undergo surgery had preoperative pelvic magnetic resonance imaging with and without contrast to better assess the feasibility of laparoscopic surgery and possibly suggest signs of malignancy [12]. The route of the myomectomy was recommended to the patient on the basis of pelvic examination, imaging, her desire for fertility, the number and sizes of myomas present, and the surgeon's impression of the feasibility of removing the symptom-causing myomas either laparoscopically or through an open abdominal incision.…”

Section: Methodsmentioning

confidence: 99%

Quality of Life after Laparoscopic and Open Abdominal Myomectomy

Rodriguez-Triana¹,

Kwan²,

Kelly³

et al. 2021

Journal of Minimally Invasive Gynecology

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Study Objective: To evaluate the baseline and postoperative changes in quality of life and symptom-severity scores in women undergoing laparoscopic or open abdominal myomectomy for symptomatic myomas. Design: Prospective cohort study of patients choosing myomectomy for symptomatic uterine myomas. Setting: Academic medical center. Patients: A total of 143 women enrolled in the study. Of these, 80 women completed both a preoperative questionnaire and at least 1 postoperative questionnaire between 6 and 27 months after surgery. Interventions: A total of 52 women had open abdominal myomectomy, and 28 had laparoscopic myomectomy between October 2014 and September 2017. Measurements and Main Results: The results of the Uterine Fibroid Symptom and Health-Related Quality-of-Life Questionnaire were compared before and after laparoscopic or open myomectomy.Women undergoing open abdominal myomectomy had larger and more numerous myomas than women undergoing laparoscopic myomectomy. Baseline quality-oflife scores were less adversely affected for women having laparoscopic myomectomy (mean [standard deviation], 57 [24] laparoscopic vs 43 [19] open abdominal, p = .01). However, baseline symptom-severity scores were statistically similar (49 [22] for laparoscopic and 57 [20] for open abdominal, p = .08) approaches. Six to 12 months after surgery, both open abdominal and laparoscopic surgeries provided excellent and similar improvements in symptom-severity and quality of life (postoperative symptoms severity scores, mean [standard deviation], 20 [14] laparoscopic vs 13 [11] open abdominal, p = .24 and quality-of-life scores, mean [standard deviation], 91 [16] laparoscopic vs 88 [17] open abdominal, p = .49). These improvements were sustained for women who returned questionnaires up to 27 months of follow-up. Conclusion: Women with symptomatic myomas have a compromised quality of life, and they experience a similarly dramatic improvement in quality of life and decrease in symptom-severity after both laparoscopic and open abdominal myomectomies.

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“…Author A.S. (reader a), an obstetrician and gynecologist with more than 20 years of experience, who has knowledge in this eld and has written a review paper, evaluated the images of all study cases and developed the diagnostic algorithm 5 . For the test set to evaluate the inter-examiner agreement, we randomly selected 31 leiomyomas with high T2WI (including 14 algorithm-positive cases) and 16 leiomyomas with low T2WI (including 16 algorithm-positive cases), in addition to 14 sarcoma cases with available DWI images in the Kindai cohort I and II.…”

Section: Evaluation Methods Of Inter-examiner Agreementmentioning

confidence: 99%

“…On the other hand, many reports suggest that uterine sarcoma can be differentiated from leiomyoma by magnetic resonance imaging (MRI). Characteristic ndings of uterine sarcoma include high T2 weighted Image (WI), diffusion weighted image (DWI), and T1WI, and unclear margins 5 . Recently, there have been studies to differentiate atypical degenerative myoma from sarcoma, based on the consensus that it is easy to differentiate typical myoma from sarcoma 6 .…”

Section: Introductionmentioning

confidence: 99%

Development of an Algorithm To Differentiate Uterine Sarcoma From Fibroid Using MRI and LDH Levels

Suzuki

Kido

Matsuki

et al. 2021

Preprint

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This study aimed to establish an evaluation method for detecting uterine sarcoma with 100% sensitivity using MRI and serum LDH levels. One evaluator reviewed the MRI images and LDH values of a total of 1801 cases, including 36 cases of uterine sarcoma and 1765 cases of uterine fibroids. The reproducibility of the algorithm was also examined using a test set of 61 cases, including 14 cases of uterine sarcoma, by four evaluators with different imaging experience and abilities. From the MRI images and LDH values of 1801 cases of uterine sarcoma and uterine fibroid, we found that all sarcomas were included in the group with high T2WI and either high T1WI, unclear margin, or high LDH value. In addition, when cases with DWI were examined, all sarcomas had high DWI. Among the 36 sarcoma cases, the group with positive findings in T2WI, T1WI, margin, and serum LDH levels all had a poor prognosis (p = 0.015). The reproducibility of the algorithm was examined by four evaluators, and the sensitivity of sarcoma detection ranged from 71–93%. We established an algorithm that is not uterine sarcoma if tumors in the myometrium with low T2WI and DWI.

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Differential Diagnosis of Uterine Leiomyoma and Uterine Sarcoma Using Magnetic Resonance Images: A Literature Review

Cited by 34 publications

References 25 publications

Metabolomic Profiling of Peripheral Plasma by GC-MS and Correlation With Size of Uterine Leiomyomas

Metabolomic Profiling of Peripheral Plasma by GC-MS and Correlation With Size of Uterine Leiomyomas

Quality of Life after Laparoscopic and Open Abdominal Myomectomy

Development of an Algorithm To Differentiate Uterine Sarcoma From Fibroid Using MRI and LDH Levels

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