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: To assess the accuracy of ultrasound in the differential diagnosis between uterine leiomyomas and sarcomas. Data sources: 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: 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: 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: Ultrasound seems to have only a moderate diagnostic accuracy in the differential diagnosis between uterine leiomyomas and sarcomas, with a lower sensitivity than specificity.

Diagnostic Accuracy of Ultrasound in the Diagnosis of Uterine Leiomyomas and Sarcomas / Raffone, Antonio; Raimondo, Diego; Neola, Daniele; Travaglino, Antonio; Raspollini, Arianna; Giorgi, Matteo; Santoro, Angela; De Meis, Lucia; Zannoni, Gian Franco; Seracchioli, Renato; Casadio, Paolo; Guida, Maurizio. - In: JOURNAL OF MINIMALLY INVASIVE GYNECOLOGY. - ISSN 1553-4650. - 31:1(2024), pp. 28-36.e1. [10.1016/j.jmig.2023.09.013]

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

Raffone, Antonio;Neola, Daniele;Travaglino, Antonio;Santoro, Angela;Guida, Maurizio
2024

Abstract

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: To assess the accuracy of ultrasound in the differential diagnosis between uterine leiomyomas and sarcomas. Data sources: 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: 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: 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: Ultrasound seems to have only a moderate diagnostic accuracy in the differential diagnosis between uterine leiomyomas and sarcomas, with a lower sensitivity than specificity.
2024
Diagnostic Accuracy of Ultrasound in the Diagnosis of Uterine Leiomyomas and Sarcomas / Raffone, Antonio; Raimondo, Diego; Neola, Daniele; Travaglino, Antonio; Raspollini, Arianna; Giorgi, Matteo; Santoro, Angela; De Meis, Lucia; Zannoni, Gian Franco; Seracchioli, Renato; Casadio, Paolo; Guida, Maurizio. - In: JOURNAL OF MINIMALLY INVASIVE GYNECOLOGY. - ISSN 1553-4650. - 31:1(2024), pp. 28-36.e1. [10.1016/j.jmig.2023.09.013]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/954016
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