ArticleAbdominal radiology (New York)2026
Biparametric MRI-based nomogram for differentiating malignant from atypical benign uterine smooth muscle tumors.
Article in Abdominal radiology (New York), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo develop and validate a biparametric MRI (bpMRI)-based nomogram for distinguishing malignant or potentially malignant uterine smooth muscle tumors from atypical benign leiomyomas. MATERIALS AND
methodsIn this retrospective study, patients who underwent MRI for atypical uterine masses from January 2012 to January 2023 and subsequently underwent surgery were identified. MRI was performed using 1.5 Tesla or 3 Tesla scanners, including T2-weighted, diffusion-weighted sequences, and ADC maps. Two experienced radiologists evaluated lesions for qualitative features (i.e., T1/ T2 signal intensity, margins, presence of haemorrhage, DWI restriction) and quantitative mean ADC values. Histopathology served as the reference standard. Logistic regression identified significant predictors of malignancy, which were incorporated into a point-based nomogram. Receiver Operating Characteristic (ROC) analysis assessed model performance; interobserver agreement was evaluated using Cohen's kappa.
resultsEighty-nine lesions from 77 patients (median age, 45.6 years) were included. Malignant and potentially malignant lesions were 26 (30%), and 63 (70%) were benign. On multivariate analysis, irregular margins, hyperintense T2 signal, hyperintense DWI signal, and low ADC values (≤ 0.998 × 10⁻
conclusionA biparametric MRI-based nomogram using reproducible, contrast-free imaging features can help accurately differentiate malignant from benign uterine smooth muscle tumors. This tool may guide preoperative management, particularly when CE-MRI is unavailable or contraindicated.
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