{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T11:11:24Z","timestamp":1791976284121,"version":"4.4.0"},"reference-count":42,"publisher":"Cambridge University Press (CUP)","issue":"2","license":[{"start":{"date-parts":[[2018,4,12]],"date-time":"2018-04-12T00:00:00Z","timestamp":1523491200000},"content-version":"unspecified","delay-in-days":101,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int J Technol Assess Health Care"],"published-print":{"date-parts":[[2018]]},"abstract":"<jats:p><jats:bold>Objectives:<\/jats:bold>There are no current established pathognomonic diagnostic features for uterine leiomyosarcomas in the pre- or perioperative setting. Recent inadvertent upstaging of this rare malignancy during laparoscopic morcellation of a presumed fibroid has prompted widespread debate among clinicians regarding the safety of current surgical techniques for management of fibroids. This study aims to conduct a systematic review investigating significant diagnostic features in magnetic resonance imaging (MRI) of uterine leiomyosarcomas.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold>A comprehensive database search was conducted guided by PRISMA recommendations for peer-reviewed publications to November 2017. Parameters available in MRI were compared for reliability and accuracy of diagnosis of leiomyosarcomas. A decision tree algorithm classifier model was constructed to investigate whether T1 and T2 MRI signal intensities are useful indicators.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold>Nine eligible studies were identified for analysis. There appears to be a significant relationship between histopathological type and T1 and T2 intensity signals (<jats:italic>p<\/jats:italic>&lt; .05). A decision tree model analyzing T1 and T2 signal intensity readings supports this trend, with a diagnostic specificity of 77.78 percent for uterine leiomyosarcomas. The apparent diffusion coefficient (ADC) values were not observed to have a significant relationship with tumor pathology (<jats:italic>p<\/jats:italic>= .18).<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold>Various studies have investigated pre- and perioperative techniques in differentiating uterine leiomyosarcoma from benign fibroids. Given the rarity of the malignancy and lack of pathognomonic diagnostic parameters, there is difficulty in establishing definitive criteria. A decision tree model is proposed to aid diagnosis based on MRI signal intensities.<\/jats:p>","DOI":"10.1017\/s0266462318000168","type":"journal-article","created":{"date-parts":[[2018,4,12]],"date-time":"2018-04-12T08:16:01Z","timestamp":1523520961000},"page":"172-179","source":"Crossref","is-referenced-by-count":34,"title":["PREOPERATIVE MAGNETIC RESONANCE IMAGING DIAGNOSTIC FEATURES OF UTERINE LEIOMYOSARCOMAS: A SYSTEMATIC REVIEW"],"prefix":"10.1017","volume":"34","author":[{"given":"Helen","family":"Kaganov","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Ades","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Stuart","family":"Fraser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2018,4,12]]},"reference":[{"key":"S0266462318000168_ref040","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.10382"},{"key":"S0266462318000168_ref039","first-page":"595","article-title":"Diagnostic accuracy of needle biopsy of uterine leiomyosarcoma","volume":"7","author":"Shibata","year":"2000","journal-title":"Oncol Rep"},{"key":"S0266462318000168_ref038","doi-asserted-by":"crossref","first-page":"e0149465","DOI":"10.1371\/journal.pone.0149465","article-title":"The value of diffusion-weighted imaging in the differential diagnosis of ovarian lesions: A meta-analysis","volume":"11","author":"Kim","year":"2016","journal-title":"PLoS One"},{"key":"S0266462318000168_ref037","doi-asserted-by":"publisher","DOI":"10.1097\/RLI.0b013e3181c8ceac"},{"key":"S0266462318000168_ref035","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-31012-6_34"},{"key":"S0266462318000168_ref034","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.12.028"},{"key":"S0266462318000168_ref036","doi-asserted-by":"publisher","DOI":"10.3802\/jgo.2011.22.4.275"},{"key":"S0266462318000168_ref012","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.12.002"},{"key":"S0266462318000168_ref031","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1997.09020101.x"},{"key":"S0266462318000168_ref017","doi-asserted-by":"crossref","first-page":"2922","DOI":"10.1002\/ijc.22239","article-title":"Incidence patterns of soft tissue sarcomas, regardless of primary site, in the surveillance, epidemiology and end results program, 1978\u20132001: An analysis of 26,758 cases","volume":"119","author":"Toro","year":"2006","journal-title":"Int J Cancer"},{"key":"S0266462318000168_ref033","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinimag.2014.06.004"},{"key":"S0266462318000168_ref022","doi-asserted-by":"publisher","DOI":"10.1006\/gyno.1995.9965"},{"key":"S0266462318000168_ref028","unstructured":"R Core Team. R: A language and environment for statistical computing. R version 3.2.2. R Foundation for Statistical Computing. 2015."},{"key":"S0266462318000168_ref026","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2009.09.023"},{"key":"S0266462318000168_ref006","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-007-0787-7"},{"key":"S0266462318000168_ref009","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.24998"},{"key":"S0266462318000168_ref007","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2007.08.019"},{"key":"S0266462318000168_ref005","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1438.2007.00818.x"},{"key":"S0266462318000168_ref010","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1016\/j.fertnstert.2007.01.093","article-title":"symptomatology, and diagnosis of uterine myomas","volume":"87","author":"Etiology","year":"2007","journal-title":"Fertil Steril"},{"key":"S0266462318000168_ref004","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.20207"},{"key":"S0266462318000168_ref014","first-page":"16","article-title":"FDA warns against power morcellation for hysterectomy and fibroids","volume":"114","author":"Wallis","year":"2014","journal-title":"Am J Nurs"},{"key":"S0266462318000168_ref013","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.03.019"},{"key":"S0266462318000168_ref041","first-page":"361","article-title":"Telomerase activity in needle biopsied uterine myoma-like tumors: Differential diagnosis between uterine sarcomas and leiomyomas","volume":"20","author":"Tsujimura","year":"2002","journal-title":"Int J Oncol"},{"key":"S0266462318000168_ref023","first-page":"543","article-title":"Malignant transformation of uterine leiomyomata","volume":"29","author":"Indraccolo","year":"2008","journal-title":"Eur J Gynaecol Oncol"},{"key":"S0266462318000168_ref042","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1016\/j.jmig.2014.06.010","article-title":"Biopsy of uterine leiomyomata and frozen sections before laparoscopic morcellation","volume":"21","author":"Tulandi","year":"2014","journal-title":"J Minim Invasive Gynecol"},{"key":"S0266462318000168_ref001","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/0090-8258(89)90855-X","article-title":"Uterine leiomyosarcoma-magnetic resonance imaging","volume":"32","author":"Janus","year":"1989","journal-title":"Gynecol Oncol"},{"key":"S0266462318000168_ref002","doi-asserted-by":"publisher","DOI":"10.1007\/BF02718391"},{"key":"S0266462318000168_ref003","doi-asserted-by":"publisher","DOI":"10.1016\/0730-725X(95)93813-5"},{"key":"S0266462318000168_ref008","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2009.03.005"},{"key":"S0266462318000168_ref011","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2014.08.781"},{"key":"S0266462318000168_ref015","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1002\/9781118655344.ch15","volume-title":"Uterine leiomyosarcoma. Uncommon gynecologic cancers","author":"del Carmen","year":"2014"},{"key":"S0266462318000168_ref016","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2011.06.002"},{"key":"S0266462318000168_ref018","unstructured":"Tinelli A . Uterine leiomyosarcomas and leiomyomas: Two similar uterine solid tumors, totally different for prognosis. http:\/\/www.sciedupress.com\/journal\/index.php\/jst\/article\/view\/430 (accessed March 6, 2018)."},{"key":"S0266462318000168_ref019","first-page":"392","article-title":"Potential biomarker for human uterine leiomyosarcoma","volume":"6","author":"Hayashi","year":"2014","journal-title":"J Clin Med Res"},{"key":"S0266462318000168_ref020","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.177.6.1771307"},{"key":"S0266462318000168_ref021","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.181.5.1811369"},{"key":"S0266462318000168_ref024","doi-asserted-by":"publisher","DOI":"10.5152\/dir.2014.14053"},{"key":"S0266462318000168_ref025","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1148\/radiol.12120315","article-title":"The added role of MR imaging in treatment stratification of patients with gynecologic malignancies: What the radiologist needs to know","volume":"266","author":"Rockall","year":"2013","journal-title":"Radiology"},{"key":"S0266462318000168_ref027","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2535"},{"key":"S0266462318000168_ref029","first-page":"256","article-title":"Performance analysis of naive Bayes and J48 classification algorithm for data classification","volume":"6","author":"Patil","year":"2013","journal-title":"Int J Comput Sci Appl"},{"key":"S0266462318000168_ref030","first-page":"294","article-title":"Transvaginal color Doppler for assessment of uterine vascularity in cases of uterine fibroids and sarcomas","volume":"3","year":"2003","journal-title":"Ultrasound Rev Obstet Gynecol"},{"key":"S0266462318000168_ref032","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1438.2002.01086.x"}],"container-title":["International Journal of Technology Assessment in Health Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0266462318000168","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,2]],"date-time":"2023-09-02T02:04:45Z","timestamp":1693620285000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0266462318000168\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018]]},"references-count":42,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018]]}},"alternative-id":["S0266462318000168"],"URL":"https:\/\/doi.org\/10.1017\/s0266462318000168","relation":{},"ISSN":["0266-4623","1471-6348"],"issn-type":[{"value":"0266-4623","type":"print"},{"value":"1471-6348","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018]]}}}