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Preoperative identification from occult leiomyosarcomas in laparoscopic hysterectomy and laparoscopic myomectomy: accuracy of the ultrasound scoring system (PRESS-US)

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机构: [1]Department of Ultrasound, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Afliated Cancer Hospital of University of Electronic Science and Technology of China (UESTC), NO. 55, Section 4, Renmin South Road, Chengdu 610041, China [2]Department of Pathology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Afliated Cancer Hospital of University of Electronic Science and Technology of China (UESTC), Chengdu 610041, China [3]Department Gynecologic Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Afliated Cancer Hospital of University of Electronic Science and Technology of China (UESTC), NO. 55, Section 4, Renmin South Road, Chengdu 610041, China [4]Department of Ultrasound, Suining Central Hospital, Suining 629000, China
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关键词: Uterine mass Leiomyosarcomas Leiomyomas Ultrasound scoring system Gynecological malignancies

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To assess the diagnostic performance and inter-observer agreement of a PREoperative sarcoma scoring based on ultrasound (PRESS-US) in differentiating uterine leiomyosarcoma (uLMS) from leiomyoma (LM).We conducted a retrospective evaluation of patients who underwent surgery and received standardized ultrasound examinations due to the presence of uterine myoma-like masses. Histological diagnosis was used as the reference standard. The masses were analyzed using morphological uterus sonographic assessment criteria, and the diagnostic accuracy of PRESS-US was evaluated using ROC curve analysis. Kappa (κ) statistics were used to assess the inter-observer agreement between a less experienced and an expert radiologist.Among the 646 patients, 632 (97.8%) were diagnosed with LM, and 14 (2.2%) had uLMS. The malignancy rates for low-risk and high-risk patients were 0.35% and 13.48%, respectively. The optimal PRESS-US cutoff was 17.5, resulting in an AUC of 89.7% (95% CI, 0.79-1.00), with a sensitivity of 85.7% and a specificity of 87.8%. The inter-observer agreement between a less experienced and an expert radiologist was excellent (κ = 0.811, P < 0.001).PRESS-US provides effective risk stratification for uLMS for radiologists with different levels of experience, with high reliability. Subgrouping high-risk patients helps in better risk stratification.© 2024. Italian Society of Medical Radiology.

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大类 | 2 区 医学
小类 | 2 区 核医学
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大类 | 2 区 医学
小类 | 2 区 核医学
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Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
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Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

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第一作者机构: [1]Department of Ultrasound, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Afliated Cancer Hospital of University of Electronic Science and Technology of China (UESTC), NO. 55, Section 4, Renmin South Road, Chengdu 610041, China
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