Multicenter Study of MRI Features in Uterine Myxoid Leiomyosarcoma: Revealing and Overcoming a Critical Pitfall in Current Consensus Criteria
Year: 2026
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: To clarify the qualitative and quantitative MRI features of myxoid leiomyosarcoma (MLMS) in comparison with conventional leiomyosarcoma (cLMS) and to identify the specific diagnostic pitfalls of the current consensus criteria when applied to the MLMS subtype. MATERIALS AND METHODS: This retrospective multicenter study (12 institutions) included patients with histopathologically confirmed leiomyosarcoma (MLMS or cLMS) who underwent preoperative MRI. A total of 38 women (15 with MLMS and 23 with cLMS; median age, 55 years) were evaluated. Three radiologists independently evaluated features, including T2 signal patterns (purely hyperintense, mixed, iso-to-moderately hyperintense) and a characteristic "marbled appearance" (heterogeneous signal intermingling). The tumors were classified as benign or malignant on the basis of the apparent diffusion coefficient (ADC) values in accordance with the current consensus criteria. A histogram analysis was performed using multiparametric sequences. RESULTS: = 0.007). CONCLUSION: Strict reliance on ADC-based consensus criteria may lead to systematic under-recognition of MLMS. Recognizing the "marbled appearance" on MRI is crucial to prevent misclassifying these tumors as benign.
Source: Korean Journal of Radiology
Institutions: University of Tsukuba, University of Tsukuba Hospital, Tottori University, Tsukuba Medical Center Hospital, National Cancer Center Hospital, Osaka Medical and Pharmaceutical University, Kyoto University, Kindai University, The University of Osaka, Fujita Health University, Shinshu University, Shinshu University Hospital, National Cancer Center Hospital East, Hitachi General Hospital, Hitachi (Japan), Toyama University Hospital, University of Toyama
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7204235471