Current Status of Magnetic Resonance Imaging in Patients with Malignant Uterine Neoplasms: A Review

Huang, Yu‐Ting; Huang, Yen-Ling; Ng, Koon‐Kwan; Lin, Gigin

doi:10.3348/kjr.2018.0090

Cited by 25 publications

(24 citation statements)

References 85 publications

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“…Concerns about occult sarcomas have changed practice in recent years, and although improved imaging techniques for distinguishing them from noncancers are emerging, they remain limited in diagnostic scope, [11,12] and predictive modeling has not yet been sufficiently successful [13]. However, other pathologies may also be present in presumed benign disease [14−18].…”

Section: Discussionmentioning

confidence: 99%

Incidence of Gynecologic Cancers in Women after Uterine Artery Embolization

Bronico¹,

Matthews²,

Perkins³

et al. 2021

Journal of Minimally Invasive Gynecology

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Study Objective: To characterize the short-term incidence of gynecologic cancer after undergoing uterine artery embolization (UAE). Design: Retrospective cohort study. Setting: Commercial insurance claims database. Patients: Total of 15 393 United States women aged 18 to 64 years who underwent UAE between 2007 and 2017.Interventions: We used the IBM MarketScan (Armonk, NY) claims to identify adult women without previous gynecologic cancer diagnoses undergoing UAE between 2007 and 2017. Database queries identified women with any diagnostic or procedure codes related to gynecologic malignancies occurring in the first 3 years after UAE. A malignancy diagnosis was suggested by recurrent malignancy-related claims not linked exclusively to diagnostic testing (e.g., transvaginal ultrasound) and malignancy codes linked to tissue pathology claims. Incidence of malignancy diagnosis was calculated. Rates of endometrial sampling in the year before UAE were identified. Measurements and Main Results: Thirty-one women undergoing UAE had gynecologic cancer diagnoses within 3 years of the procedure (22 of 31, 71% uterine cancers; 7 of 31, 23% ovarian cancers; and 2 of 31, 6% cervical cancers). On average, cancer diagnoses were made 1.1 § 0.9 years after UAE. One in 497 women undergoing UAE was diagnosed with a gynecologic malignancy within 3 years, with an incidence of 1.1 malignancies per 1000 person-years. Cancer incidence increased with age at the time of UAE: short-term malignancy diagnoses were made in 1 in 377 women aged 45 to 54 years, and 1 in 79 women aged 55 to 64 years. In the year before UAE, 28% (4311 of 15 362) of women without cancer, and 23% (5 of 22) of women diagnosed with uterine cancer had preprocedural endometrial sampling. Conclusion: These data can inform risk/benefit counseling and shared decision-making regarding UAE and its alternatives. Short-term malignancies after UAE highlight the importance of preprocedure evaluation in symptomatic women and women with age-related risk.

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Section: Discussionmentioning

confidence: 99%

Incidence of Gynecologic Cancers in Women after Uterine Artery Embolization

Bronico¹,

Matthews²,

Perkins³

et al. 2021

Journal of Minimally Invasive Gynecology

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show abstract

“…Therefore, in order to manage accurately initial treatment plans, MRI, DWI, and ADC value should be fully applied to gather multiple high-risk factors. MRI is already widely used in diagnosis of endometrial carcinoma (26). DWI is recommended because it improves the detection and characterization of uterine tumors and the visualization of small implants in peritoneal carcinomatosis; it also provides better sensitivity and maintains similar specificity, as compared with conventional MRI (26,27).…”

Section: Discussionmentioning

confidence: 99%

The prominent value of apparent diffusion coefficient in assessing high-risk factors and prognosis for patients with endometrial carcinoma before treatment

Quan

Xuan

et al. 2020

Acta Radiol

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Background To date, there are no consensus methods to evaluate the high-risk factors and prognosis for managing the personalized treatment schedule of patients with endometrial carcinoma (EC) before treatment. Apparent diffusion coefficient (ADC) is regarded as a kind of technique to assess heterogeneity of malignant tumor. Purpose To explore the role of ADC value in assessing the high-risk factors and prognosis of EC. Material and Methods A retrospective analysis was made on 185 patients with EC who underwent 1.5-T magnetic resonance imaging (MRI). Mean ADC (mADC), minimum ADC (minADC), and maximum ADC (maxADC) were measured and compared in different groups. Results Among the 185 patients with EC, the mADC and maxADC values in those with high-risk factors (type 2, deep myometrial invasion, and lymph node metastasis) were significantly lower than in those without. According to receiver operating characteristic (ROC) curve analysis, the areas under the curve (AUC) were significant for mADC, minADC, and maxADC predicting high-risk factors. Furthermore, the AUCs were significant for mADC and maxADC predicting lymph node metastasis but were not significant for minADC. Patients with lower mADC were associated with worse overall survival and disease-free survival; the opposite was true for patients with higher mADC. Conclusion Our study showed that ADC values could be applied to assess the high-risk factors of EC before treatment and might significantly relate to the prognosis of EC. It might contribute to managing initial individualized treatment schedule and improve outcome in patients with EC.

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“…These are large masses that may develop into hemorrhagic necrosis and infiltration. In many cases, HGESS shows heterogeneous contrast effects, equivalent to or stronger compared to that of peripheral normal myometrium, considered a significant finding in differentiating HGESS from endometrial cancer [4,5,9].…”

Section: Endometrial Stromal Sarcoma (Ess)mentioning

confidence: 99%

“…Red degeneration accompanying pregnancy presents high signals in T1WI, and, in images, these are ascertained as tumor hemorrhage typical of sarcoma. Hence, there is an overlap in respective image findings for benign uterine myoma and malignant uterine sarcoma, indicating that there is a limitation in establishing an accurate diagnosis of sarcoma from image findings alone [3][4][5]9]. However, since findings suggestive of sarcoma are widely known, it is possible to "definitely ascertain masses that are potentially sarcomas" if they are not overlooked in radiological interpretations.…”

Section: Differentiating Between Uterine Myoma and Sarcomamentioning

confidence: 99%

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

et al. 2019

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MRI plays an essential role in patients before treatment for uterine mesenchymal malignancies. Although MRI includes methods such as diffusion-weighted imaging and dynamic contrast-enhanced MRI, the differentiation between uterine myoma and sarcoma always becomes problematic. The present paper discusses important findings to ensure that sarcomas are not overlooked in magnetic resonance (MR) images, and we describe the update in the differentiation between uterine leiomyoma and sarcoma with recent reports.

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Current Status of Magnetic Resonance Imaging in Patients with Malignant Uterine Neoplasms: A Review

Cited by 25 publications

References 85 publications

Incidence of Gynecologic Cancers in Women after Uterine Artery Embolization

Incidence of Gynecologic Cancers in Women after Uterine Artery Embolization

The prominent value of apparent diffusion coefficient in assessing high-risk factors and prognosis for patients with endometrial carcinoma before treatment

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

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