biostudies-literatureUnknown94(1125)Sahin H<h4>Objective</h4>To assess the value of non-contrast MRI features for characterisation of uterine leiomyosarcoma (LMS) and differentiation from atypical benign leiomyomas.<h4>Methods</h4>This study included 57 atypical leiomyomas and 16 LMS which were referred pre-operatively for management review to the specialist gynaeoncology multidisciplinary team meeting. Non-contrast MRIs were retrospectively reviewed by five independent readers (three senior, two junior) and a 5-level Likert score (1-low/5-high) was assigned to each mass for likelihood of LMS. Evaluation of qualitative and quantitative MRI features was done using uni- and multivariable regression analysis. Inter-reader reliability for the assessment of MRI features was calculated by using Cohen's κ values.<h4>Results</h4>In the univariate analysis, interruption of the endometrial interface and irregular tumour shape had the highest odds ratios (ORs) (64.00, <i>p</i> < 0.001 and 12.00, <i>p</i> = 0.002, respectively) for prediction of LMS. Likert score of the mass was significant in prediction (OR, 3.14; <i>p</i> < 0.001) with excellent reliability between readers (ICC 0.86; 95% CI, 0.76-0.92). The post-menopausal status, interruption of endometrial interface and thickened endometrial stripe were the most predictive independent variables in multivariable estimation of the risk of leiomyosarcoma with an accuracy of 0.88 (95%CI, 0.78-0.94).<h4>Conclusion</h4>At any level of expertise as a radiologist reader, the loss of the normal endometrial stripe (either thickened or not seen) in a post-menopausal patient with a myometrial mass was highly likely to be LMS.<h4>Advances in knowledge</h4>This study demonstrates the potential utility of non-contrast MRI features in characterisation of LMS over atypical leiomyomas, and therefore influence on optimal management of these cases.The British journal of radiology20210115https://www.ebi.ac.uk/biostudies/studies/S-EPMC9327768biostudies-literatureDiagnostic interpretation of non-contrast qualitative MR imaging features for characterisation of uterine leiomyosarcoma.PMC9327768Sahin HCarmisciano LAddley HShakur ACaglic IZawaideh JPBruining AFreeman SJimenez-Linan MSmith JfalseDiagnostic interpretation of non-contrast qualitative MR imaging features for characterisation of uterine leiomyosarcoma.<h4>Objective</h4>To assess the value of non-contrast MRI features for characterisation of uterine leiomyosarcoma (LMS) and differentiation from atypical benign leiomyomas.<h4>Methods</h4>This study included 57 atypical leiomyomas and 16 LMS which were referred pre-operatively for management review to the specialist gynaeoncology multidisciplinary team meeting. Non-contrast MRIs were retrospectively reviewed by five independent readers (three senior, two junior) and a 5-level Likert score (1-low/5-high) was assigned to each mass for likelihood of LMS. Evaluation of qualitative and quantitative MRI features was done using uni- and multivariable regression analysis. Inter-reader reliability for the assessment of MRI features was calculated by using Cohen's κ values.<h4>Results</h4>In the univariate analysis, interruption of the endometrial interface and irregular tumour shape had the highest odds ratios (ORs) (64.00, <i>p</i> < 0.001 and 12.00, <i>p</i> = 0.002, respectively) for prediction of LMS. Likert score of the mass was significant in prediction (OR, 3.14; <i>p</i> < 0.001) with excellent reliability between readers (ICC 0.86; 95% CI, 0.76-0.92). The post-menopausal status, interruption of endometrial interface and thickened endometrial stripe were the most predictive independent variables in multivariable estimation of the risk of leiomyosarcoma with an accuracy of 0.88 (95%CI, 0.78-0.94).<h4>Conclusion</h4>At any level of expertise as a radiologist reader, the loss of the normal endometrial stripe (either thickened or not seen) in a post-menopausal patient with a myometrial mass was highly likely to be LMS.<h4>Advances in knowledge</h4>This study demonstrates the potential utility of non-contrast MRI features in characterisation of LMS over atypical leiomyomas, and therefore influence on optimal management of these cases.2021-01-01T00:00:00Z2021 Sep2025-05-31T22:50:47.537Z2025-05-31T22:50:47.537ZS-EPMC93277683411197310.1259/bjr.20210115