Diagnostic Accuracy of Ultrasound in the Diagnosis of Uterine Leiomyomas and Sarcomas.

Leiomyosarcoma Malignancy Myomata Neoplasia Prediction Preoperative assessment Uterus

Journal

Journal of minimally invasive gynecology
ISSN: 1553-4669
Titre abrégé: J Minim Invasive Gynecol
Pays: United States
ID NLM: 101235322

Informations de publication

Date de publication:
29 Sep 2023
Historique:
received: 25 06 2023
revised: 08 08 2023
accepted: 26 09 2023
pubmed: 2 10 2023
medline: 2 10 2023
entrez: 1 10 2023
Statut: aheadofprint

Résumé

Differential diagnosis between uterine leiomyomas and sarcomas is challenging. Ultrasound shows an uncertain role in the clinical practice given that pooled estimates about its diagnostic accuracy are lacking. To assess the accuracy of ultrasound in the differential diagnosis between uterine leiomyomas and sarcomas. A systematic review was performed searching 5 electronic databases (MEDLINE, Web of Sciences, Google Scholar, Scopus, and ClinicalTrial.gov) from their inception to June 2023. All peer-reviewed observational or randomized clinical trials that reported an unbiased postoperative histologic diagnosis of uterine leiomyoma or uterine sarcoma that also comprised a preoperative ultrasonographic evaluation of the uterine mass. Sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratio, and area under the curve on summary receiver operating characteristic were calculated for each included study and as pooled estimate, with 95% confidence interval (CI); 972 women (694 with uterine leiomyomas and 278 with uterine sarcomas) were included. Ultrasound showed pooled sensitivity of 0.76 (95% CI, 0.70-0.81), specificity of 0.89 (95% CI, 0.87-0.92), positive and negative likelihood ratios of 6.65 (95% CI, 4.45-9.93) and 0.26 (95% CI, 0.07-1.0) respectively, diagnostic odds ratio of 23.06 (95% CI, 4.56-116.53), and area under the curve of 0.8925. Ultrasound seems to have only a moderate diagnostic accuracy in the differential diagnosis between uterine leiomyomas and sarcomas, with a lower sensitivity than specificity.

Sections du résumé

BACKGROUND BACKGROUND
Differential diagnosis between uterine leiomyomas and sarcomas is challenging. Ultrasound shows an uncertain role in the clinical practice given that pooled estimates about its diagnostic accuracy are lacking.
OBJECTIVES OBJECTIVE
To assess the accuracy of ultrasound in the differential diagnosis between uterine leiomyomas and sarcomas.
DATA SOURCES METHODS
A systematic review was performed searching 5 electronic databases (MEDLINE, Web of Sciences, Google Scholar, Scopus, and ClinicalTrial.gov) from their inception to June 2023.
METHODS OF STUDY SELECTION METHODS
All peer-reviewed observational or randomized clinical trials that reported an unbiased postoperative histologic diagnosis of uterine leiomyoma or uterine sarcoma that also comprised a preoperative ultrasonographic evaluation of the uterine mass.
TABULATION, INTEGRATION, AND RESULTS RESULTS
Sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratio, and area under the curve on summary receiver operating characteristic were calculated for each included study and as pooled estimate, with 95% confidence interval (CI); 972 women (694 with uterine leiomyomas and 278 with uterine sarcomas) were included. Ultrasound showed pooled sensitivity of 0.76 (95% CI, 0.70-0.81), specificity of 0.89 (95% CI, 0.87-0.92), positive and negative likelihood ratios of 6.65 (95% CI, 4.45-9.93) and 0.26 (95% CI, 0.07-1.0) respectively, diagnostic odds ratio of 23.06 (95% CI, 4.56-116.53), and area under the curve of 0.8925.
CONCLUSIONS CONCLUSIONS
Ultrasound seems to have only a moderate diagnostic accuracy in the differential diagnosis between uterine leiomyomas and sarcomas, with a lower sensitivity than specificity.

Identifiants

DOI: 10.1016/j.jmig.2023.09.013 PMID: 37778636
pubmed: 37778636
pii: S1553-4650(23)00864-6
doi: 10.1016/j.jmig.2023.09.013
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 AAGL. All rights reserved.

Auteurs

Antonio Raffone (A)

Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy (Drs. Raffone, Raspollini, and Seracchioli); Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy (Drs. Raffone, Neola, and Guida).

Diego Raimondo (D)

Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy (Drs. Raimondo, Raspollini, De Meis, Seracchioli, and Casadio). Electronic address: diego.raimondo@aosp.bo.it.

Daniele Neola (D)

Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy (Drs. Raffone, Neola, and Guida).

Antonio Travaglino (A)

Unit of Pathology, Department of Medicine and Technological Innovation, University of Insubria, Varese, Italy (Dr. Travaglino).

Arianna Raspollini (A)

Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy (Drs. Raffone, Raspollini, and Seracchioli); Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy (Drs. Raimondo, Raspollini, De Meis, Seracchioli, and Casadio).

Matteo Giorgi (M)

Department of Molecular and Developmental Medicine, Obstetrics and Gynecological Clinic, University of Siena, Siena, Italy (Dr. Giorgi).

Angela Santoro (A)

Gynecopathology and Breast Pathology Unit, Department of Woman's Health Science, Agostino Gemelli University Polyclinic, Rome, Italy (Drs. Santoro and Zannoni).

Lucia De Meis (L)

Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy (Drs. Raimondo, Raspollini, De Meis, Seracchioli, and Casadio).

Gian Franco Zannoni (GF)

Gynecopathology and Breast Pathology Unit, Department of Woman's Health Science, Agostino Gemelli University Polyclinic, Rome, Italy (Drs. Santoro and Zannoni).

Renato Seracchioli (R)

Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy (Drs. Raffone, Raspollini, and Seracchioli); Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy (Drs. Raimondo, Raspollini, De Meis, Seracchioli, and Casadio).

Paolo Casadio (P)

Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy (Drs. Raimondo, Raspollini, De Meis, Seracchioli, and Casadio).

Maurizio Guida (M)

Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy (Drs. Raffone, Neola, and Guida).

Classifications MeSH