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Preoperative Ultrasound-Guided Needle Biopsy of 63 Uterine Tumors Having High Signal Intensity Upon T2-Weighted Magnetic Resonance Imaging

Tamura, Ryo MD*; Kashima, Katsunori MD, PhD*; Asatani, Mina MD, PhD; Nishino, Koji MD, PhD*; Nishikawa, Nobumichi MD, PhD*; Sekine, Masayuki MD, PhD*; Serikawa, Takehiro MD, PhD*; Enomoto, Takayuki MD, PhD*

International Journal of Gynecological Cancer: July 2014 - Volume 24 - Issue 6 - p 1042–1047
doi: 10.1097/IGC.0000000000000189
Uterine Cancer

Objective The differential diagnosis between uterine sarcoma and benign leiomyoma is difficult when made only by magnetic resonance imaging (MRI); it usually requires an additional preoperative diagnostic procedure. We report our results using ultrasound-guided needle biopsy for these types of uterine tumors.

Methods Ultrasound-guided needle biopsy was performed on 63 patients with uterine smooth muscle tumors suspected of malignancy by MRI. We compared the results of presurgical biopsy against the postsurgical pathology of the tumor.

Results Among 63 patients with a high signal intensity of the uterine tumor on T2-weighted MRI (1 case was undetermined), 12 cases (19.3%) were diagnosed by the needle biopsy as malignant, and 51 cases (80.6%) were benign. Among the 12 diagnosed as malignant tumors, 11 had surgery performed, and one was treated with chemotherapy. Among the 51 patients diagnosed with a benign tumor, 27 had surgery performed, and 24 were put on a wait-and-see clinical follow-up schedule. One of the 27 surgical patients with a benign tumor had a postsurgical diagnosis of a low-grade endometrial stromal sarcoma. In the 38 cases where surgery was performed, we found the sensitivity, specificity, and the positive and negative predictive values of the needle biopsy were 91.7%, 100%, 100%, and 96.2%, respectively.

Conclusions Ultrasound-guided needle biopsy may be a reliable preoperative diagnostic procedure for uterine tumors with suspected malignancy.

Departments of *Obstetrics and Gynecology, and †Radiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.

Address correspondence and reprint requests to Dr Katsunori Kashima, Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo Ward, Niigata City, 951-8510, Japan. E-mail:

The authors declare no conflicts of interest.

Received February 18, 2014

Accepted May 2, 2014

© 2014 by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology.