Article Figures & Data
Figures
- 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.
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, ×40. Arrows indicate mitotic figures).
- 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, ×100. Arrows show myxoid degeneration).
- 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, ×100. Arrows indicate severe cytologic atypia).
Tables
- TABLE 1
Clinical and Histopathologic Findings in 70 Patients Suspected of Having Nonbenign USMTs
Finding n Histopathologic Nonbenign USMTs LMS 10 Smooth muscle tumors of uncertain malignant potential (USMTsUMP) 5 Benign USMTs Uncomplicated 26 Mitotically active variant 1 Cellular variant 1 Hemorrhagic cellular variant 1 Myxoid variant 20 Atypical variant 1 Lipoleiomyoma variant 3 Uncomplicated plus adenomyosis 2 Clinical Total number of patients Nonbenign USMTs 15 Benign USMTs 55 Average age (y) Nonbenign USMTs 53.6 ± 15.1 (28–77)* Benign USMTs 49.5 ± 8.2 (30–64)* Total number of postmenopausal patients Nonbenign USMTs 10 Benign USMTs 23 Average tumor size (cm) Nonbenign USMTs 10.7 ± 5.76 (4–20)† Benign USMTs 7.82 ± 2.65 (5–15)† Number of metastasis Nonbenign USMTs 0 Benign USMTs 0 ↵* P > 0.05 (no significant difference in average age of patients between nonbenign USMT and benign USMT groups).
↵† P > 0.05 (no significant difference in tumor size between nonbenign USMT and benign USMT groups).
Data for average age and tumor size are mean ± SD, with minimum and maximum values in parentheses.
Sensitivity Specificity Imaging technique Percentage CI Percentage CI Accuracy (%) MRI (%) 73.3 (11/15) 0.45–0.91 85.5 (47/55) 0.73–0.93 82.9 (58/70) 18F-FDG PET (%) 86.7 (13/15) 0.58–0.98 92.7 (51/55) 0.82–0.98 91.4 (64/70) MRI plus 18F-FDG PET (%) 93.3 (14/15) 0.66–0.99 92.7 (51/55) 0.82–0.98 92.9 (65/70) Probable nonbenign results were considered positive for the purpose of analysis.
