"It allows classifying uterine masses as benign (myoma) or malignant (sarcoma) and to reduce the number of indeterminate uterine masses," first study author Dr. Cendos Abdel Wahab, a radiology resident at European Georges Pompidou Hospital in Paris, told AuntMinnie.com. "This may help optimize therapeutic management by indicating carcinological surgery for malignant tumors (no morcellation) and reducing the number of surgeries for benign tumors."
The study included 113 women whose atypical uterine masses were seen on MRI prior to surgery. The researchers collected clinical and MRI data and compared the results with pathological findings. Only 50% of sarcomas presented as a single uterine mass.
The most notable factors for predicting malignancy were the patient's age, irregular contours, intratumoral hemorrhage, T2 signal intensity greater than the endometrium on diffusion-weighted imaging (DWI), and apparent diffusion coefficient (ADC) values.
In addition, diffusion and perfusion MRI sequences appear to be key predictors of malignancy with an atypical uterine mass, which would help guide the patient's therapy.
The researchers noted that their study brings three pieces of new information. "The first is that an area of low T2 signal intensity in a heterogeneous uterine mass, even small, is always a sign of benignity," Wahab said. "The second is a guide to read DWI by using internal references spontaneously in high signal intensity on DWI. The third is an ADC cutoff value of 0.905, below which masses are malignant in 97% of cases."
