Differentiation of Uterine Leiomyosarcoma from Atypical Leiomyoma: Diagnostic Accuracy of Qualitative MR Imaging Features and Feasibility of Texture Analysis.

Purpose: To investigate whether qualitative magnetic resonance (MR) features can distinguish leiomyosarcoma (LMS) from atypical leiomyoma (ALM) and assess the feasibility of texture analysis (TA).Methods: This retrospective study included 41 women (ALM = 22, LMS = 19) imaged with MRI prior to surger...

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Publicado en:European Radiology Vol. 27; no. 7; pp. 2903 - 2916
Autores principales: Lakhman, Yulia, Veeraraghavan, Harini, Chaim, Joshua, Feier, Diana, Goldman, Debra, Moskowitz, Chaya, Nougaret, Stephanie, Sosa, Ramon, Vargas, Hebert, Soslow, Robert, Abu-Rustum, Nadeem, Hricak, Hedvig, Sala, Evis, Goldman, Debra A, Moskowitz, Chaya S, Sosa, Ramon E, Vargas, Hebert Alberto, Soslow, Robert A, Abu-Rustum, Nadeem R
Formato: diagnostic images research tables/charts Journal Article
Publicado: Springer Nature Jul2017
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul2017
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00330-016-4623-9
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        atl: Differentiation of Uterine Leiomyosarcoma from Atypical Leiomyoma: Diagnostic Accuracy of Qualitative MR Imaging Features and Feasibility of Texture Analysis.
      aug:
        au:
          Lakhman, Yulia
          Veeraraghavan, Harini
          Chaim, Joshua
          Feier, Diana
          Goldman, Debra
          Moskowitz, Chaya
          Nougaret, Stephanie
          Sosa, Ramon
          Vargas, Hebert
          Soslow, Robert
          Abu-Rustum, Nadeem
          Hricak, Hedvig
          Sala, Evis
          Goldman, Debra A
          Moskowitz, Chaya S
          Sosa, Ramon E
          Vargas, Hebert Alberto
          Soslow, Robert A
          Abu-Rustum, Nadeem R
        affil: Department of Radiology , Memorial Sloan Kettering Cancer Center , New York USA
      sug:
        subj:
          Uterine Neoplasms Pathology
          Magnetic Resonance Imaging Methods
          Leiomyoma Pathology
          Leiomyosarcoma Diagnosis
          Aged
          Young Adult
          Pilot Studies
          Aged, 80 and Over
          Female
          Diagnosis, Differential
          Middle Age
          Adult
          Reproducibility of Results
          Retrospective Design
          Adolescence
          Funding Source
          Human
          Aged: 65+ years
          Aged, 80 & over
          Middle Aged: 45-64 years
          Adult: 19-44 years
          Adolescent: 13-18 years
          Female
      ab: Purpose: To investigate whether qualitative magnetic resonance (MR) features can distinguish leiomyosarcoma (LMS) from atypical leiomyoma (ALM) and assess the feasibility of texture analysis (TA).Methods: This retrospective study included 41 women (ALM = 22, LMS = 19) imaged with MRI prior to surgery. Two readers (R1, R2) evaluated each lesion for qualitative MR features. Associations between MR features and LMS were evaluated with Fisher's exact test. Accuracy measures were calculated for the four most significant features. TA was performed for 24 patients (ALM = 14, LMS = 10) with uniform imaging following lesion segmentation on axial T2-weighted images. Texture features were pre-selected using Wilcoxon signed-rank test with Bonferroni correction and analyzed with unsupervised clustering to separate LMS from ALM.Results: Four qualitative MR features most strongly associated with LMS were nodular borders, haemorrhage, "T2 dark" area(s), and central unenhanced area(s) (p ≤ 0.0001 each feature/reader). The highest sensitivity [1.00 (95%CI:0.82-1.00)/0.95 (95%CI: 0.74-1.00)] and specificity [0.95 (95%CI:0.77-1.00)/1.00 (95%CI:0.85-1.00)] were achieved for R1/R2, respectively, when a lesion had ≥3 of these four features. Sixteen texture features differed significantly between LMS and ALM (p-values: <0.001-0.036). Unsupervised clustering achieved accuracy of 0.75 (sensitivity: 0.70; specificity: 0.79).Conclusions: Combination of ≥3 qualitative MR features accurately distinguished LMS from ALM. TA was feasible.Key Points: • Four qualitative MR features demonstrated the strongest statistical association with LMS. • Combination of ≥3 these features could accurately differentiate LMS from ALM. • Texture analysis was a feasible semi-automated approach for lesion categorization.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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