Imaging characteristics of uterine smooth muscle tumors of uncertain malignant potential: a case report and literature review.

Uterine smooth muscle tumors of uncertain malignant potential (STUMPs) are rare tumors of the uterine myometrium that are often misdiagnosed, owing to limited knowledge of their characteristics on ultrasonography (US) and magnetic resonance imaging (MRI). We report a woman in her mid-30s who was hospitalized because of a pelvic tumor. A 6-cm mass was found in her lower left abdomen. US and MRI revealed a well-demarcated mass in the left adnexal area, with both cystic and solid elements, visible blood flow within the septa, a strong signal across >50% of the volume on T2-weighted imaging (T2WI), and a strong signal on diffusion-weighted imaging (DWI). After hysterectomy and bilateral salpingectomy, immunohistochemical examination confirmed STUMP. A review of the literature revealed characteristic imaging features of STUMP. Ultrasonography reveals STUMP as a solitary, well-circumscribed lesion with isoechoic or mixed echogenicity, the absence of posterior shadowing, and variations in blood flow. STUMP is characterized by strong signal intensity on T2WI, small areas of strong signal on T1WI, and non-enhancing cystic areas on contrast-enhanced MRI scans. Early diagnosis is crucial for the management and treatment of STUMP, and here we have summarized the imaging features of the lesion, thereby providing a valuable diagnostic reference.

Evaluation of Multislice Spiral Computed Tomography Perfusion Imaging for the Efficacy of Preoperative Concurrent Chemoradiotherapy in Middle-aged and Elderly Patients with Locally Advanced Gastric Cancer.

BACKGROUND This study aimed to investigate the predictive value of multislice spiral computed tomography (MSCT) perfusion imaging for the efficacy of preoperative concurrent chemoradiotherapy (CCRT) in middle-aged and elderly patients with locally advanced gastric cancer (LAGC). MATERIAL AND METHODS One-hundred twenty-six middle-aged and elderly patients with LAGC were selected. MSCT was performed before and after CCRT to obtain perfusion parameters: blood flow volume (BF), blood volume (BV), mean transit time (MTT), and permeability surface (PS). After CCRT, according to Response Evaluation Criteria in Solid Tumors (RECIST), patients were categorized into the effective group and the ineffective group. Overall survival rate was measured by Kaplan-Meier analysis. ROC curve was applied to evaluate the predictive value of perfusion parameters. Multiple logistic regression analysis was applied to analyze the association of perfusion parameters with the efficacy of preoperative treatment. RESULTS Tumor volume reduction rates of the effective and ineffective groups were 59.23±8.53% and 10.41±3.36%. BF, BV, and PS values in the effective group were significantly decreased after CCRT. ROC curves indicated high sensitivities and specificities of BF value (79.00%, 73.44%), BV value (71.00%, 75.00%), and PS value (82.30%, 90.63%). The incidence rate of weakness and anorexia in the effective group was much higher than that in the ineffective group. Patients with low BF, BV, and PS values (less their optimal cutoff values) had longer survival times than these with high BF, BV, and PS values. CONCLUSIONS MSCT might have predictive values for the efficacy of preoperative CCRT in the treatment of LAGC.

Role of diffusion-weighted magnetic resonance imaging and apparent diffusion coefficient values in the detection of gastric carcinoma.

OBJECTIVE: The study evaluated the applicability of diffusion-weighted magnetic resonance imaging (DW-MRI) and apparent diffusion coefficient (ADC) values in the diagnosis and staging of gastric carcinoma (GC). METHODS: From December, 2013 to December, 2014, 35 GC patients were selected from the Department of Oncology. Carcinomatous gastric tissues were collected as the case group, and normal gastric tissues were collected as the control group. The DW-MRI examination was performed on a 3.0-T GE Signa Excite MRI scanner. The ADC values of carcinomatous and normal gastric tissues were measured. A statistical meta-analysis was further performed. RESULTS: DW-MRI identified 75.0% (3/4) patients with T1, 75.0% (6/8) patients with T2, 86.4% (19/22) patients with T3, and 100.0% (1/1) patient with T4, showing an accuracy for T staging of 82.9% (29/35); identified 92.9% (13/14) patients of N0, 58.3% (7/12) patents of N1, 62.5% (5/8) patents of N2, and 100.0% (1/1) patients of N3, showing an accuracy for N staging of 74.3% (26/35). The average ADC value in the case group was apparently lower than the control group (P < 0.001); in the poorly differentiated group was lower than the moderately and well differentiated groups (F = 111.1, P < 0.001). Pairwise comparison of the average ADC value between the poorly, moderately and well differentiated groups showed statistical significance (all P < 0.05). Meta-analysis further confirmed a higher average ADC value in the case group than the control group (SMD = -4.136, 95% CI = -5.344~-2.928, P < 0.001). CONCLUSION: DW-MRI is proved to be an attractive, noninvasive, quantitative and useful technique in the diagnosis and staging of GC.