How to differentiate uterine leiomyosarcoma from leiomyoma with imaging

Publication date: Available online 16 August 2019Source: Diagnostic and Interventional ImagingAuthor(s): S. Sun, P.A. Bonaffini, S. Nougaret, L. Fournier, A. Dohan, J. Chong, J. Smith, H. Addley, C. ReinholdAbstractUterine leiomyomas, the most frequent benign myomatous tumors of the uterus, often cannot be distinguished from malignant uterine leiomyosarcomas using clinical criteria. Furthermore, imaging differentiation between both entities is frequently challenging due to their potential overlapping features. Because a suspected leiomyoma is often managed conservatively or with minimally invasive treatments, the misdiagnosis of leiomyosarcoma for a benign leiomyoma could potentially result in significant treatment delays, therefore increasing morbidity and mortality. In this review, we provide an overview of the differences between leiomyoma and leiomyosarcoma, mainly focusing on imaging characteristics, but also briefly touching upon their demographic, histopathological and clinical differences. The main indications and limitations of available cross-sectional imaging techniques are discussed, including ultrasound, computed tomography, magnetic resonance imaging (MRI) and positron emission tomography/computed tomography. A particular emphasis is placed on the review of specific MRI features that may allow distinction between leiomyomas and leiomyosarcomas according to the most recent evidence in the literature. The potential contribution of texture analysis is also discusse...
Source: Diagnostic and Interventional Imaging - Category: Radiology Source Type: research