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Sonographic and Magnetic Resonance Characteristics of Gynecological Sarcoma

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,...

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Autores principales: Camponovo, Carolina, Neumann, Stephanie, Zosso, Livia, Mueller, Michael D., Raio, Luigi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10092971/
https://www.ncbi.nlm.nih.gov/pubmed/37046441
http://dx.doi.org/10.3390/diagnostics13071223
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author Camponovo, Carolina
Neumann, Stephanie
Zosso, Livia
Mueller, Michael D.
Raio, Luigi
author_facet Camponovo, Carolina
Neumann, Stephanie
Zosso, Livia
Mueller, Michael D.
Raio, Luigi
author_sort Camponovo, Carolina
collection PubMed
description 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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spelling pubmed-100929712023-04-13 Sonographic and Magnetic Resonance Characteristics of Gynecological Sarcoma Camponovo, Carolina Neumann, Stephanie Zosso, Livia Mueller, Michael D. Raio, Luigi Diagnostics (Basel) Systematic Review 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. MDPI 2023-03-23 /pmc/articles/PMC10092971/ /pubmed/37046441 http://dx.doi.org/10.3390/diagnostics13071223 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Systematic Review
Camponovo, Carolina
Neumann, Stephanie
Zosso, Livia
Mueller, Michael D.
Raio, Luigi
Sonographic and Magnetic Resonance Characteristics of Gynecological Sarcoma
title Sonographic and Magnetic Resonance Characteristics of Gynecological Sarcoma
title_full Sonographic and Magnetic Resonance Characteristics of Gynecological Sarcoma
title_fullStr Sonographic and Magnetic Resonance Characteristics of Gynecological Sarcoma
title_full_unstemmed Sonographic and Magnetic Resonance Characteristics of Gynecological Sarcoma
title_short Sonographic and Magnetic Resonance Characteristics of Gynecological Sarcoma
title_sort sonographic and magnetic resonance characteristics of gynecological sarcoma
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10092971/
https://www.ncbi.nlm.nih.gov/pubmed/37046441
http://dx.doi.org/10.3390/diagnostics13071223
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