{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:18:24Z","timestamp":1792189104398,"version":"4.4.0"},"reference-count":47,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,1,13]],"date-time":"2019-01-13T00:00:00Z","timestamp":1547337600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Uterine fibroids are a common benign tumor and can be symptomatic, necessitating resection. Surgical myomectomy is an effective treatment option with a risk of disseminating occult uterine leiomyosarcoma (LMS), creating a need for an effective presurgical screening protocol. Clinical collaboration with contrast\u2010enhanced MRI including T<jats:sub>2<\/jats:sub> and diffusion\u2010weighted imaging (DWI) can be utilized as a screening exam.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To review the accuracy and feasibility of an interdisciplinary prospective contrast\u2010enhanced MRI pelvis with DWI screening system for LMS prior to fibroid resection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Type<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>In all, 1960 adult female patients aged 18\u201387 undergoing screening MRI pelvis prior to uterine fibroid resection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Field Strength\/Sequence<\/jats:title><jats:p>T<jats:sub>1<\/jats:sub> and T<jats:sub>2<\/jats:sub>\u2010weighted imaging, DWI, and contrast\u2010enhanced images were acquired at 1.5 T and 3.0 T.<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>Each radiologist at the time of clinical study prospectively designated a confidence level of presence of LMS in the impression, which was reviewed retrospectively. A separate retrospective evaluation of the histologically proven LMS and the false positives was performed for the presence of five MRI features of LMS including low ADC values, intermediate\/high T<jats:sub>2<\/jats:sub> signal intensity, irregular margins, hemorrhage, and necrosis. A preliminary cost\u2010effectiveness analysis was performed, comparing the costs of treatment of uterine fibroids with vs. without a collaborative screening protocol using MRI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>Sensitivity, specificity, positive predictive value, and negative predictive value were obtained from the prospective evaluations. Student's <jats:italic>t<\/jats:italic>\u2010tests were used to compare demographics and apparent diffusion coefficient values between LMS and false\u2010positive results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We prospectively identified LMS patients with 100% sensitivity and 97% specificity. Preliminary cost analysis demonstrated that the MR screening protocol increased life expectancy by 0.04 years at a cost of $12,937 per life\u2010year gained.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>MRI is an effective and potentially economic screening test, especially with standardized reporting and coordination with clinicians.<\/jats:p><jats:p><jats:bold>Level of Evidence:<\/jats:bold> 3<\/jats:p><jats:p><jats:bold>Technical Efficacy Stage:<\/jats:bold> 2<\/jats:p><jats:p>J. Magn. Reson. Imaging 2019.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.26630","type":"journal-article","created":{"date-parts":[[2019,1,14]],"date-time":"2019-01-14T07:35:06Z","timestamp":1547451306000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["MRI screening for uterine leiomyosarcoma"],"prefix":"10.1002","volume":"49","author":[{"given":"Angela","family":"Tong","sequence":"first","affiliation":[{"name":"Department of Radiology New York University Langone Health  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2402-3787","authenticated-orcid":false,"given":"Stella K.","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Radiology New York University Langone Health  New York New York USA"},{"name":"Department of Population Health New York University Langone Health  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenchan","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Radiology New York University Langone Health  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology New York University Langone Health  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Slevin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology New York University Langone Health  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Hindman","sequence":"additional","affiliation":[{"name":"Department of Radiology New York University Langone Health  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,1,13]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"CD004638","article-title":"Minimally invasive surgical techniques versus open myomectomy for uterine fibroids","author":"Bhave Chittawar P","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2016.10.024"},{"key":"e_1_2_5_4_1","unstructured":"Laparoscopic Uterine Power Morcellation in Hysterectomy and Myomectomy\u2014FDA Safety Communication. 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