A predictive diagnostic model using multiparametric MRI for differentiating uterine carcinosarcoma from carcinoma of the uterine corpus

作者：Kamishima Yuki; Takeuchi Mitsuru; Kawai Tatsuya; Kawaguchi Takatsune; Yamaguchi Ken; Takahashi Naoki; Ito Masato; Arakawa Toshinao; Yamamoto Akiko; Suzuki Kazushi; Ogawa Masaki; Takeuchi Moe; Shibamoto Yuta

来源：Japanese Journal of Radiology, 2017, 35(8): 472-483.

DOI：10.1007/s11604-017-0655-6

• Magnetic resonance imaging
• Uterus
• Endometrial neoplasms
• Carcinosarcoma
• Carcinoma

Purpose To construct a diagnostic model for differentiating carcinosarcoma from carcinoma of the uterus.
Materials and methods Twenty-six patients with carcinosarcomas and 26 with uterine corpus carcinomas constituted a derivation cohort. The following nine MRI features of the tumors were evaluated: inhomogeneity, predominant signal intensity, presence of hyper-and hypointense areas, conspicuity of tumor margin, cervical canal extension on T2WI, presence of hyperintense areas on T1WI, contrast defect area volume percentage, and degree of enhancement. Two predictive models-with and without contrast-were constructed using multivariate logistic regression analysis. Fifteen other patients with carcinosarcomas and 30 patients with carcinomas constituted a validation cohort. The sensitivity and specificity of each model for the validation cohort were calculated.
Results Inhomogeneity, predominant signal intensity on T2WI, and presence of hyperintense areas on T1WI were significant predictors in the unenhanced-MRI-based model. Presence of hyperintensity on T1WI, contrast defect area volume percentage, and degree of enhancement were significant predictors in the enhanced-MRI-based model. The sensitivity/specificity of unenhanced MRI were 87/73 and 87/70% according to reviewer 1 and 2, respectively. The sensitivity/specificity of the enhanced-MRI-based model were 87/70% according to both reviewers.
Conclusions Our diagnostic models can differentiate carcinosarcoma from carcinoma of the uterus with high sensitivity and moderate specificity.

• 出版日期2017-8