{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:18:27Z","timestamp":1792189107045,"version":"4.4.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"1119","license":[{"start":{"date-parts":[[2021,1,28]],"date-time":"2021-01-28T00:00:00Z","timestamp":1611792000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To assess accuracy of and interobserver agreement on multiparametric MR findings to distinguish uterine leiomyoma (LM) from uterine leiomyosarcoma (LMS) and soft tissue tumour of unknown malignant potential.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Inclusion criteria: All females over 18 years with least one uterine mass measuring 5\u2009cm or more in at least one of the three standard orthogonal dimensions on MR with histopathological confirmation of LM, LMS, or soft tissue tumour of unknown malignant potential (STUMP) in the 3 months following MR. Patients with LMS were drawn from a larger cohort being assessed for MR-guided focussed ultrasound (MRgFUS) suitability. Image evaluation: Assessed variables were: lesion margin, margin definition, T2 signal homogeneity, &amp;gt;50% of lesion with T2 signal brighter than myometrium, haemorrhage, restricted diffusion, contrast enhancement (CE), CE pattern, local lymphadenopathy and ascites.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>32 LM, 10 LMS and 1 STUMP were evaluated. Ill-defined (p-value = 0.0003\u20130.0004) or irregular (p = 0.003\u20130.004) lesion margin, T2 hyperintensity &amp;gt;50% (p = 0.001\u20130.004), and peripheral CE (p = 0.02\u20130.05) were significantly more common in LMS\/STUMP than LM for both radiologists. 10\/11 (Reader 2) and 11\/11 (Reader 1) LMS\/STUMP displayed restricted diffusion but so did 63\u201380% of LM. Agreement was greatest for margin characteristics (\u03ba = 0.73\u20130.81).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Irregular\/ill-defined lesion margin best distinguished LMS\/STUMP from LM with good interrater reliability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Advances in knowledge:<\/jats:title>\n                    <jats:p>Assessment of agreement regarding MR parameters distinguishing LM from LMS and STUMP has not previously been undertaken in a cohort including a large number of patients with LMS. This will help inform evaluation of females considering minimally invasive LM treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1259\/bjr.20200483","type":"journal-article","created":{"date-parts":[[2021,1,28]],"date-time":"2021-01-28T14:41:22Z","timestamp":1611844882000},"source":"Crossref","is-referenced-by-count":20,"title":["Multiparametric MR evaluation of uterine leiomyosarcoma and STUMP versus leiomyoma in symptomatic women planned for high frequency focussed ultrasound: accuracy of imaging parameters and interobserver agreement for identification of malignancy"],"prefix":"10.1093","volume":"94","author":[{"given":"Parisa","family":"Aminzadeh","sequence":"first","affiliation":[{"name":"Royal Women\u2019s Hospital , Parkville, Victoria , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ekaterina","family":"Alibrahim","sequence":"additional","affiliation":[{"name":"Royal Women\u2019s Hospital , Parkville, Victoria , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Dobrotwir","sequence":"additional","affiliation":[{"name":"Royal Women\u2019s Hospital , Parkville, Victoria , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eldho","family":"Paul","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Preventive Medicine, Monash University, Commercial Road, Prahran , Victoria , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacy","family":"Goergen","sequence":"additional","affiliation":[{"name":"Royal Women\u2019s Hospital , Parkville, Victoria , Australia"},{"name":"Monash Imaging, Monash Health , Clayton, Victoria , Australia"},{"name":"School of Clinical Sciences, Monash University , Clayton, Victoria , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,1,28]]},"reference":[{"key":"2024050215205535800_b1","first-page":"424","article-title":"Epidemiology of uterine Myomas: a review","volume":"9","author":"Sparic","year":"2016","journal-title":"Int J Fertil Steril"},{"key":"2024050215205535800_b2","doi-asserted-by":"crossref","first-page":"319.e1","DOI":"10.1016\/j.ajog.2013.07.017","article-title":"The impact of uterine leiomyomas: a national survey of affected women","volume":"209","author":"Borah","year":"2013","journal-title":"Am J Obstet Gynecol"},{"key":"2024050215205535800_b3","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1097\/AOG.0000000000002331","article-title":"Comparative effectiveness of uterine leiomyoma procedures using a large insurance claims database","volume":"130","author":"Borah","year":"2017","journal-title":"Obstet Gynecol"},{"key":"2024050215205535800_b4","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1016\/j.fertnstert.2006.11.080","article-title":"Influence of hysterectomy on long-term fracture risk","volume":"88","author":"Melton","year":"2007","journal-title":"Fertil Steril"},{"key":"2024050215205535800_b5","doi-asserted-by":"crossref","first-page":"664.e1","DOI":"10.1016\/j.ajog.2007.08.064","article-title":"Incidence of pelvic floor repair after hysterectomy: a population-based cohort study","volume":"197","author":"Blandon","year":"2007","journal-title":"Am J Obstet Gynecol"},{"key":"2024050215205535800_b6","doi-asserted-by":"crossref","first-page":"1462","DOI":"10.1161\/01.CIR.0000159344.21672.FD","article-title":"Risk of cardiovascular disease by hysterectomy status, with and without oophorectomy: the women's health Initiative observational study","volume":"111","author":"Howard","year":"2005","journal-title":"Circulation"},{"key":"2024050215205535800_b7","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1159\/000314681","article-title":"Hysterectomy, oophorectomy and risk of dementia: a nationwide historical cohort study","volume":"30","author":"Phung","year":"2010","journal-title":"Dement Geriatr Cogn Disord"},{"key":"2024050215205535800_b8","article-title":"Quantitative assessment of the prevalence of unsuspected uterine sarcoma in women undergoing treatment of uterine fibroids-summary and key findings"},{"key":"2024050215205535800_b9","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1007\/s10397-015-0894-4","article-title":"The prevalence of occult leiomyosarcoma at surgery for presumed uterine fibroids: a meta-analysis","volume":"12","author":"Pritts","year":"2015","journal-title":"Gynecol Surg"},{"key":"2024050215205535800_b10","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1002\/9781118655344.ch15","volume-title":"Uncommon Gynecologic Cancers","author":"del Carmen","year":"2014"},{"key":"2024050215205535800_b11","doi-asserted-by":"crossref","first-page":"1762","DOI":"10.1007\/s00261-017-1076-9","article-title":"Magnetic resonance imaging features of uterine sarcoma and mimickers","volume":"42","author":"Barral","year":"2017","journal-title":"Abdom Radiol"},{"key":"2024050215205535800_b12","doi-asserted-by":"crossref","first-page":"2332","DOI":"10.1007\/s00261-016-0935-0","article-title":"Mr imaging of atypical fibroids","volume":"41","author":"Bolan","year":"2016","journal-title":"Abdom Radiol"},{"key":"2024050215205535800_b13","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1046\/j.1525-1438.2002.01086.x","article-title":"Usefulness of Gd-DTPA contrast-enhanced dynamic MRI and serum determination of LDH and its isozymes in the differential diagnosis of leiomyosarcoma from degenerated leiomyoma of the uterus","volume":"12","author":"Goto","year":"2002","journal-title":"Int J Gynecol Cancer"},{"key":"2024050215205535800_b14","doi-asserted-by":"crossref","first-page":"213","DOI":"10.2214\/AJR.11.7287","article-title":"Uterine sarcomas: then and now","volume":"199","author":"Shah","year":"2012","journal-title":"AJR Am J Roentgenol"},{"key":"2024050215205535800_b15","doi-asserted-by":"crossref","first-page":"1228","DOI":"10.1111\/aogs.13008","article-title":"Preoperative evaluation in women with uterine leiomyosarcoma. A nationwide cohort study","volume":"95","author":"Skorstad","year":"2016","journal-title":"Acta Obstet Gynecol Scand"},{"key":"2024050215205535800_b16","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/j.jmig.2017.08.660","article-title":"Magnetic resonance imaging grading system for preoperative diagnosis of leiomyomas and uterine smooth muscle tumors","volume":"25","author":"Suzuki","year":"2018","journal-title":"J Minim Invasive Gynecol"},{"key":"2024050215205535800_b17","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1007\/s00261-012-9919-x","article-title":"Current concepts in the imaging of uterine sarcoma","volume":"38","author":"Tirumani","year":"2013","journal-title":"Abdom Imaging"},{"key":"2024050215205535800_b18","doi-asserted-by":"crossref","first-page":"4","DOI":"10.5152\/dir.2014.14053","article-title":"Uterine sarcomas: clinical presentation and MRI features","volume":"21","author":"Santos","year":"2015","journal-title":"Diagn Interv Radiol"},{"key":"2024050215205535800_b19","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1002\/jmri.24998","article-title":"Comparison of the diagnostic accuracy of contrast-enhanced MRI and diffusion-weighted MRI in the differentiation between uterine leiomyosarcoma \/ smooth muscle tumor with uncertain malignant potential and benign leiomyoma","volume":"43","author":"Lin","year":"2016","journal-title":"J Magn Reson Imaging"},{"key":"2024050215205535800_b20","doi-asserted-by":"crossref","first-page":"3125","DOI":"10.1007\/s00330-017-5157-5","article-title":"European Society of urogenital radiology (ESUR) guidelines: MR imaging of leiomyomas","volume":"28","author":"Kubik-Huch","year":"2018","journal-title":"Eur Radiol"},{"key":"2024050215205535800_b21","doi-asserted-by":"crossref","first-page":"2903","DOI":"10.1007\/s00330-016-4623-9","article-title":"Differentiation of uterine leiomyosarcoma from atypical leiomyoma: diagnostic accuracy of qualitative MR imaging features and feasibility of texture analysis","volume":"27","author":"Lakhman","year":"2017","journal-title":"Eur Radiol"},{"key":"2024050215205535800_b22","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1111\/j.1525-1438.2007.00818.x","article-title":"Unsuspected uterine leiomyosarcoma: magnetic resonance imaging findings before and after focused ultrasound surgery","volume":"17","author":"Fukunishi","year":"2007","journal-title":"Int J Gynecol Cancer"},{"key":"2024050215205535800_b23","doi-asserted-by":"crossref","DOI":"10.3802\/jgo.2018.29.e26","article-title":"What MRI features suspect malignant pure mesenchymal uterine tumors rather than uterine leiomyoma with cystic degeneration?","volume":"29","author":"Kim","year":"2018","journal-title":"J Gynecol Oncol"},{"key":"2024050215205535800_b24","doi-asserted-by":"crossref","first-page":"2306","DOI":"10.1007\/s00330-013-2819-9","article-title":"How to differentiate benign from malignant myometrial tumours using MR imaging","volume":"23","author":"Thomassin-Naggara","year":"2013","journal-title":"Eur Radiol"},{"key":"2024050215205535800_b25","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1002\/jmri.23716","article-title":"Advanced MRI in malignant neoplasms of the uterus","volume":"37","author":"Kido","year":"2013","journal-title":"J Magn Reson Imaging"},{"key":"2024050215205535800_b26","doi-asserted-by":"crossref","first-page":"368.e1","DOI":"10.1016\/j.ajog.2013.12.028","article-title":"Clinical application of diffusion-weighted imaging for preoperative differentiation between uterine leiomyoma and leiomyosarcoma","volume":"210","author":"Sato","year":"2014","journal-title":"Am J Obstet Gynecol"},{"key":"2024050215205535800_b27","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1007\/s00330-007-0787-7","article-title":"The utility of diffusion-weighted MR imaging for differentiating uterine sarcomas from benign leiomyomas","volume":"18","author":"Tamai","year":"2008","journal-title":"Eur Radiol"},{"key":"2024050215205535800_b28","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1002\/jmri.20207","article-title":"Smooth muscle tumors of uncertain malignant potential and leiomyosarcomas of the uterus: Mr findings","volume":"20","author":"Tanaka","year":"2004","journal-title":"J Magn Reson Imaging"},{"key":"2024050215205535800_b29","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.2214\/AJR.17.19234","article-title":"Uterine leiomyosarcoma: can MRI differentiate leiomyosarcoma from benign leiomyoma before treatment?","volume":"211","author":"DeMulder","year":"2018","journal-title":"AJR Am J Roentgenol"},{"key":"2024050215205535800_b30","doi-asserted-by":"crossref","first-page":"e282","DOI":"10.1002\/jmri.26630","article-title":"Mri screening for uterine leiomyosarcoma","volume":"49","author":"Tong","year":"2019","journal-title":"J Magn Reson Imaging"},{"key":"2024050215205535800_b31","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/s40644-019-0206-8","article-title":"Investigating the diagnostic value of quantitative parameters based on T2-weighted and contrast-enhanced MRI with psoas muscle and outer myometrium as internal references for differentiating uterine sarcomas from leiomyomas at 3T MRI","volume":"19","author":"Malek","year":"2019","journal-title":"Cancer Imaging"},{"key":"2024050215205535800_b32","first-page":"433","article-title":"Comparison of apparent diffusion coefficient values among different MRI platforms: a multicenter phantom study","volume":"19","author":"K\u0131vrak","year":"2013","journal-title":"Diagn Interv Radiol"},{"key":"2024050215205535800_b33","doi-asserted-by":"crossref","first-page":"2756","DOI":"10.1007\/s00330-009-1471-x","article-title":"Combined use of T2-weighted and diffusion-weighted 3-T MR imaging for differentiating uterine sarcomas from benign leiomyomas","volume":"19","author":"Namimoto","year":"2009","journal-title":"Eur Radiol"}],"container-title":["The British Journal of Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjr\/article-pdf\/94\/1119\/20200483\/57374667\/bjr.20200483.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjr\/article-pdf\/94\/1119\/20200483\/57374667\/bjr.20200483.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T12:39:44Z","timestamp":1714653584000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjr\/article\/doi\/10.1259\/bjr.20200483\/7451679"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,28]]},"references-count":33,"journal-issue":{"issue":"1119","published-online":{"date-parts":[[2021,1,28]]},"published-print":{"date-parts":[[2021,3,1]]}},"URL":"https:\/\/doi.org\/10.1259\/bjr.20200483","relation":{},"ISSN":["0007-1285","1748-880X"],"issn-type":[{"value":"0007-1285","type":"print"},{"value":"1748-880X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,3,1]]},"published":{"date-parts":[[2021,1,28]]},"article-number":"20200483"}}