MRI evaluation of uterine masses for risk of leiomyosarcoma: A consensus statement Review


Authors: Hindman, N.; Kang, S.; Fournier, L.; Lakhman, Y.; Nougaret, S.; Reinhold, C.; Sadowski, E.; Huang, J. Q.; Ascher, S.
Review Title: MRI evaluation of uterine masses for risk of leiomyosarcoma: A consensus statement
Abstract: Laparoscopic myomectomy, a common gynecologic operation in premenopausal women, has become heavily regulated since 2014 following the dissemination of unsuspected uterine leiomyosarcoma (LMS) throughout the pelvis of a physician treated for symptomatic leiomyoma. Research since that time suggests a higher prevalence than previously suspected of uterine LMS in resected masses presumed to represent leiomyoma, as high as one in 770 women (0.13%). Though rare, the dissemination of an aggressive malignant neoplasm due to noncontained electromechanical morcellation in laparoscopic myomectomy is a devastating outcome. Gynecologic surgeons' desire for an evidence-based, noninvasive evaluation for LMS is driven by a clear need to avoid such harms while maintaining the availability of minimally invasive surgery for symptomatic leiomyoma. Laparoscopic gynecologists could rely upon the distinction of higher-risk uterine masses preoperatively to plan oncologic surgery (ie, potential hysterectomy) for patients with elevated risk for LMS and, conversely, to safely offer women with no or minimal indicators of elevated risk the fertility-preserving laparoscopic myomectomy. MRI evaluation for LMS may potentially serve this purpose in symptomatic women with leiomyomas. This evidence review and consensus statement defines imaging and disease-related terms to allow more uniform and reliable interpretation and identifies the highest priorities for future research on LMS evaluation. © RSNA, 2022.
Keywords: nuclear magnetic resonance imaging; magnetic resonance imaging; hysterectomy; laparoscopy; pathology; leiomyosarcoma; uterus cancer; uterine neoplasms; myomectomy; adverse event; leiomyoma; procedures; humans; human; female; uterine myomectomy
Journal Title: Radiology
Volume: 306
Issue: 2
ISSN: 0033-8419
Publisher: Radiological Society of North America, Inc.  
Date Published: 2023-02-01
Start Page: e211658
Language: English
DOI: 10.1148/radiol.211658
PUBMED: 36194109
PROVIDER: scopus
PMCID: PMC9885356
DOI/URL:
Notes: The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Export Date: 1 March 2023 -- Source: Scopus
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  1. Yuliya Lakhman
    94 Lakhman