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First published online April 15, 2008, 10.2967/jnumed.107.047142
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Comparison of 18F-FDG PET and MRI in Assessment of Uterine Smooth Muscle Tumors

Yoshio Yoshida1, Tetsuji Kurokawa1, Yoko Sawamura1, Akiko Shinagawa1, Tetsuya Tsujikawa2, Hidehiko Okazawa2, Tatsuro Tsuchida3, Yoshiaki Imamura4, Narufumi Suganuma5 and Fumikazu Kotsuji1

1 Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, Fukui Prefecture, Japan; 2 Biomedical Imaging Research Center, Faculty of Medical Sciences, University of Fukui, Fukui Prefecture, Japan; 3 Department of Radiology, Faculty of Medical Sciences, University of Fukui, Fukui Prefecture, Japan; 4 Department of Pathology, Faculty of Medical Sciences, University of Fukui, Fukui Prefecture, Japan; and 5 Department of International Social and Health Sciences, Faculty of Medical Sciences, University of Fukui, Fukui Prefecture, Japan


Figure 1
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FIGURE 1.  Results of ROC analysis with histologic results used as reference standard. ROC curve generated for presence of nonbenign USMT demonstrates improved accuracy for MRI with 18F-FDG PET when compared with MRI alone.

 

Figure 2
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FIGURE 2.  A 66-y-old woman with LMS. (A) Sagittal MRI shows large tumor with heterogeneous high signal intensity (arrow) on T1-weighted (left) and T2-weighted (right) images (MRI score, 3). (B) Sagittal 18F-FDG PET shows 18F-FDG uptake (top arrow indicates physiologic uptake in vocal cords, bottom arrow indicates USMT, bottom arrowhead indicates liver, and top arrowhead indicates brain) equivalent to that in brain (PET score, 3). Consensus score was "nonbenign." (C) Histopathologic section of this tumor demonstrates LMS (hematoxylin-eosin stain, x40. Arrows indicate mitotic figures).

 

Figure 3
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FIGURE 3.  A 38-y-old woman with myxoid variant leiomyoma. (A) Sagittal MRI shows uterine mass with spotty pocket of high (arrow) signal intensity on T1-weighted (left) images and background of low signal intensity and a mass with central high (arrow) signal intensity on T2-weighted (right) images (MRI score, 3). (B) Sagittal 18F-FDG PET shows diffuse high (arrow) 18F-FDG uptake (arrow indicates USMT, bottom arrowhead indicates liver, and top arrowhead indicates brain) with multispots (PET score, 2). Consensus score was "probably nonbenign." (C) Histopathologic section of this tumor reveals myxoid variant leiomyoma (hematoxylin-eosin stain, x100. Arrows show myxoid degeneration).

 

Figure 4
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FIGURE 4.  A 38-y-old woman with USMTs of uncertain malignant potential. (A) Sagittal MRI shows uterine mass with low signal intensity (arrow) on T1-weighted (left) and T2-weighted (right) images (MRI score, 0). (B) Sagittal 18F-FDG PET shows equivalent-to-liver 18F-FDG uptake (arrow indicates USMT, bottom arrowhead indicates liver, and top arrowhead indicates brain) with multispots (PET score, 1). Consensus score was "benign." (C) Histopathologic section of the tumor confirms uncertain malignant potential (hematoxylin-eosin stain, x100. Arrows indicate severe cytologic atypia).

 





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