open access

Vol 91, No 7 (2020)
Research paper
Published online: 2020-06-10
Get Citation

Uterine leiomyomas: correlation between histologic composition and stiffness via magnetic resonance elastography — a Pilot Study

Marzanna Obrzut1, Bogdan Obrzut2, Marcin Zmuda3, Jakub Baran4, Marian Cholewa1, Richard Ehman5, Dorota Darmochwal-Kolarz2
·
Pubmed: 32542642
·
Ginekol Pol 2020;91(7):373-378.
Affiliations
  1. Department of Biophysics, Faculty of Mathematics and Natural Sciences, University of Rzeszow, Poland
  2. Department of Obstetrics and Gynecology, Institute of Medical Sciences, Medical College, University of Rzeszow, Poland
  3. Department of Clinical Pathomorphology, Provincial Clinical Hospital No 2 Rzeszow, Poland
  4. Institute of Nuclear Physics Polish Academy of Sciences, Cracow, Poland
  5. Department of Radiology, Mayo Clinic, USA

open access

Vol 91, No 7 (2020)
ORIGINAL PAPERS Gynecology
Published online: 2020-06-10

Abstract

Objectives: To evaluate magnetic resonance elastography as a tool for characterizing uterine leimyomas.
Material and methods: At total of 12 women with symptomatic leiomyomas diagnosed in physical and ultrasound examinations
were enrolled in this pilot study. Before surgery, all patients underwent magnetic resonance elastography of
the uterus using a 1.5 T MR whole-body scanner (Optima, GE Healthcare, Milwaukee, WI, USA). Surgical specimens were
forwarded for histological examination. The findings were allocated into 3 categories depending on the percentage content
of connective tissue: below 15%, from 15 to 30% and more than 30%. The median stiffness of leiomyomas for each of the
group was calculated. The U-Mann Whitney test was used for statistical analysis.
Results: The stiffness of the leiomyomas ranged between 3.7–6.9 kPa (median value 4.9 kPa). The concentration of extracellular
components in the leiomyomas did not exceed 40%. An increasing trend of the stiffness with the growing percentage
of extracellular component was observed. Stiffness of the leiomyomas obtained by MRE varies depending on microscopic
composition.
Conclusions: The value of stiffness shows a trend of increasing with the percentage of extracellular component of the
leiomyoma. Further studies are required to assess the usefulness of MRE in diagnostics of uterine leiomyomas.

Abstract

Objectives: To evaluate magnetic resonance elastography as a tool for characterizing uterine leimyomas.
Material and methods: At total of 12 women with symptomatic leiomyomas diagnosed in physical and ultrasound examinations
were enrolled in this pilot study. Before surgery, all patients underwent magnetic resonance elastography of
the uterus using a 1.5 T MR whole-body scanner (Optima, GE Healthcare, Milwaukee, WI, USA). Surgical specimens were
forwarded for histological examination. The findings were allocated into 3 categories depending on the percentage content
of connective tissue: below 15%, from 15 to 30% and more than 30%. The median stiffness of leiomyomas for each of the
group was calculated. The U-Mann Whitney test was used for statistical analysis.
Results: The stiffness of the leiomyomas ranged between 3.7–6.9 kPa (median value 4.9 kPa). The concentration of extracellular
components in the leiomyomas did not exceed 40%. An increasing trend of the stiffness with the growing percentage
of extracellular component was observed. Stiffness of the leiomyomas obtained by MRE varies depending on microscopic
composition.
Conclusions: The value of stiffness shows a trend of increasing with the percentage of extracellular component of the
leiomyoma. Further studies are required to assess the usefulness of MRE in diagnostics of uterine leiomyomas.

Get Citation

Keywords

leiomyoma; magnetic resonance elastography; histologic composition

About this article
Title

Uterine leiomyomas: correlation between histologic composition and stiffness via magnetic resonance elastography — a Pilot Study

Journal

Ginekologia Polska

Issue

Vol 91, No 7 (2020)

Article type

Research paper

Pages

373-378

Published online

2020-06-10

Page views

882

Article views/downloads

818

DOI

10.5603/GP.a2020.0067

Pubmed

32542642

Bibliographic record

Ginekol Pol 2020;91(7):373-378.

Keywords

leiomyoma
magnetic resonance elastography
histologic composition

Authors

Marzanna Obrzut
Bogdan Obrzut
Marcin Zmuda
Jakub Baran
Marian Cholewa
Richard Ehman
Dorota Darmochwal-Kolarz

References (42)
  1. Lumsden MA. Modern management of fibroids. Obstetrics, Gynaecology & Reproductive Medicine. 2013; 23(3): 65–70.
  2. Marsh EE, Ekpo GE, Cardozo ER, et al. Racial differences in fibroid prevalence and ultrasound findings in asymptomatic young women (18-30 years old): a pilot study. Fertil Steril. 2013; 99(7): 1951–1957.
  3. Segars JH, Parrott EC, Nagel JD, et al. Proceedings from the Third National Institutes of Health International Congress on Advances in Uterine Leiomyoma Research: comprehensive review, conference summary and future recommendations. Hum Reprod Update. 2014; 20(3): 309–333.
  4. Chegini N. Proinflammatory and profibrotic mediators: principal effectors of leiomyoma development as a fibrotic disorder. Semin Reprod Med. 2010; 28(3): 180–203.
  5. Ryan GL, Syrop CH, Van Voorhis BJ. Role, epidemiology, and natural history of benign uterine mass lesions. Clin Obstet Gynecol. 2005; 48(2): 312–324.
  6. Downes E, Sikirica V, Gilabert-Estelles J, et al. The burden of uterine fibroids in five European countries. Eur J Obstet Gynecol Reprod Biol. 2010; 152(1): 96–102.
  7. Pritts EA, Parker WH, Olive DL. Fibroids and infertility: an updated systematic review of the evidence. Fertil Steril. 2009; 91(4): 1215–1223.
  8. Kashani BN, Centini G, Morelli SS, et al. Role of Medical Management for Uterine Leiomyomas. Best Pract Res Clin Obstet Gynaecol. 2016; 34: 85–103.
  9. Thubert T, Foulot H, Vinchant M, et al. Surgical treatment: Myomectomy and hysterectomy; Endoscopy: A major advancement. Best Pract Res Clin Obstet Gynaecol. 2016; 34: 104–121.
  10. Perri T, Korach J, Sadetzki S, et al. Uterine leiomyosarcoma: does the primary surgical procedure matter? Int J Gynecol Cancer. 2009; 19(2): 257–260.
  11. Park JY, Park SK, Kim DY, et al. The impact of tumor morcellation during surgery on the prognosis of patients with apparently early uterine leiomyosarcoma. Gynecol Oncol. 2011; 122(2): 255–259.
  12. George S, Barysauskas C, Serrano C, et al. Retrospective cohort study evaluating the impact of intraperitoneal morcellation on outcomes of localized uterine leiomyosarcoma. Cancer. 2014; 120(20): 3154–3158.
  13. Leibsohn S, d'Ablaing G, Mishell D, et al. Leiomyosarcoma in a series of hysterectomies performed for presumed uterine leiomyomas. American Journal of Obstetrics and Gynecology. 1990; 162(4): 968–976.
  14. Uterine Leiomyoma. SpringerReference. .
  15. Rowland M, Lesnock J, Edwards R, et al. Occult uterine cancer in patients undergoing laparoscopic hysterectomy with morcellation: Implications for surveillance for disease recurrence and outcomes. Gynecologic Oncology. 2013; 130(1): e77.
  16. Ehdaivand S, Simon RA, Sung CJ, et al. Incidental gynecologic neoplasms in morcellated uterine specimens: a case series with follow-up. Hum Pathol. 2014; 45(11): 2311–2317.
  17. Seidman MA, Oduyebo T, Muto MG, et al. Peritoneal dissemination complicating morcellation of uterine mesenchymal neoplasms. PLoS One. 2012; 7(11): e50058.
  18. Goto A, Takeuchi S, Sugimura K, et al. Usefulness of Gd-DTPA contrast-enhanced dynamic MRI and serum determination of LDH and its isozymes in the differential diagnosis of leiomyosarcoma from degenerated leiomyoma of the uterus. Int J Gynecol Cancer. 2002; 12(4): 354–361.
  19. Tanaka YO, Nishida M, Tsunoda H, et al. Smooth muscle tumors of uncertain malignant potential and leiomyosarcomas of the uterus: MR findings. J Magn Reson Imaging. 2004; 20(6): 998–1007.
  20. Testa AC, Di Legge A, Bonatti M, et al. Imaging techniques for evaluation of uterine myomas. Best Pract Res Clin Obstet Gynaecol. 2016; 34: 37–53.
  21. Krouskop TA, Wheeler TM, Kallel F, et al. Elastic moduli of breast and prostate tissues under compression. Ultrason Imaging. 1998; 20(4): 260–274.
  22. Venkatesh SK, Yin M, Glockner JF, et al. MR elastography of liver tumors: preliminary results. AJR Am J Roentgenol. 2008; 190(6): 1534–1540.
  23. Stewart EA, Taran FA, Chen J, et al. Magnetic resonance elastography of uterine leiomyomas: a feasibility study. Fertil Steril. 2011; 95(1): 281–284.
  24. Jondal DE, Wang J, Chen J, et al. Uterine fibroids: correlations between MRI appearance and stiffness via magnetic resonance elastography. Abdom Radiol (NY). 2018; 43(6): 1456–1463.
  25. Manduca A, Oliphant TE, Dresner MA, et al. Magnetic resonance elastography: non-invasive mapping of tissue elasticity. Med Image Anal. 2001; 5(4): 237–254.
  26. Oliphant TE, Manduca A, Ehman RL, et al. Complex-valued stiffness reconstruction for magnetic resonance elastography by algebraic inversion of the differential equation. Magn Reson Med. 2001; 45(2): 299–310, doi: 10.1002/1522-2594(200102)45:2<299::aid-mrm1039>3.0.co;2-o.
  27. Manduca A, Lake DS, Kruse SA, et al. Spatio-temporal directional filtering for improved inversion of MR elastography images. Med Image Anal. 2003; 7(4): 465–473.
  28. Venkatesh SK, Ehman RL. Magnetic resonance elastography of abdomen. Abdom Imaging. 2015; 40(4): 745–759.
  29. Ichikawa S, Motosugi U, Ichikawa T, et al. Magnetic resonance elastography for staging liver fibrosis in chronic hepatitis C. Magn Reson Med Sci. 2012; 11(4): 291–297.
  30. Hennedige TP, Wang G, Leung FP, et al. Magnetic resonance elastography for the detection and staging of liver fibrosis in chronic hepatitis B. Eur Radiol. 2014; 24(1): 70–78.
  31. Huwart L, Sempoux C, Vicaut E, et al. Liver fibrosis: noninvasive assessment with MR elastography versus aspartate aminotransferase-to-platelet ratio index. Radiology. 2007; 245(2): 458–466.
  32. Kim BoH, Lee JM, Lee YeJi, et al. MR elastography for noninvasive assessment of hepatic fibrosis: experience from a tertiary center in Asia. J Magn Reson Imaging. 2011; 34(5): 1110–1116.
  33. Lee Yeji, Lee JM, Lee JE, et al. MR elastography for noninvasive assessment of hepatic fibrosis: reproducibility of the examination and reproducibility and repeatability of the liver stiffness value measurement. J Magn Reson Imaging. 2014; 39(2): 326–331.
  34. Garteiser P, Doblas S, Daire JL, et al. MR elastography of liver tumours: value of viscoelastic properties for tumour characterisation. Eur Radiol. 2012; 22(10): 2169–2177.
  35. Nedredal GI, Yin M, McKenzie T, et al. Portal hypertension correlates with splenic stiffness as measured with MR elastography. J Magn Reson Imaging. 2011; 34(1): 79–87.
  36. Shi Yu, Glaser KJ, Venkatesh SK, et al. Feasibility of using 3D MR elastography to determine pancreatic stiffness in healthy volunteers. J Magn Reson Imaging. 2015; 41(2): 369–375.
  37. Rouvière O, Souchon R, Pagnoux G, et al. Magnetic resonance elastography of the kidneys: feasibility and reproducibility in young healthy adults. J Magn Reson Imaging. 2011; 34(4): 880–886.
  38. Arani A, Da Rosa M, Ramsay E, et al. Incorporating endorectal MR elastography into multi-parametric MRI for prostate cancer imaging: Initial feasibility in volunteers. J Magn Reson Imaging. 2013; 38(5): 1251–1260.
  39. Sahebjavaher RS, Baghani A, Honarvar M, et al. Transperineal prostate MR elastography: initial in vivo results. Magn Reson Med. 2013; 69(2): 411–420.
  40. Jiang X, Asbach P, Streitberger KJ, et al. In vivo high-resolution magnetic resonance elastography of the uterine corpus and cervix. Eur Radiol. 2014; 24(12): 3025–3033.
  41. Giuntoli RL, Gostout BS, DiMarco CS, et al. Diagnostic criteria for uterine smooth muscle tumors: leiomyoma variants associated with malignant behavior. J Reprod Med. 2007; 52(11): 1001–1010.
  42. Taran FA, Weaver AL, Gostout BS, et al. Understanding cellular leiomyomas: a case-control study. Am J Obstet Gynecol. 2010; 203(2): 109.e1–109.e6.

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