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Diagnostics
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Diagnosis and Management of Uterine Lesions
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Diagnosis and Management of Uterine Lesions

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (31 May 2024) | Viewed by 13461

Special Issue Editor

Dr. Yasushi Kotani

E-Mail Website
Guest Editor
Department of Obstetrics and Gynecology, Kindai University Faculty of Medicine, Osaka, Japan
Interests: uterine lesions; hysteroscopy; laparoscopy

Special Issue Information

Dear Colleagues,

The uterus is an important reproductive organ involved in pregnancy and childbirth, but it is also an organ where a variety of diseases exist, including not only malignant tumors such as cervical cancer and uterine endometrial cancer but also benign tumors such as uterine myoma and uterine adenomyosis.

In the diagnosis of uterine lesions, the uterus can be examined directly via the vagina, and various diagnostic methods have existed for many years. In pathological diagnosis, early detection and early treatment have been performed because cytological and histological diagnoses can be performed. In imaging diagnosis, the use of diagnostic techniques such as ultrasonography, CT, MRI, and, more recently, PET scans has increased over the years. Furthermore, it is now possible to examine the lumen directly via a hysteroscopy. In this Special Issue, we welcome submissions on new findings regarding uterine lesions and their diagnosis and management that are more accurate than conventional methods.

Dr. Yasushi Kotani
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • diagnostic
  • management
  • uterine lesions
  • pathology
  • imaging
  • hysteroscopy

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Published Papers (5 papers)

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Research

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11 pages, 2636 KiB  
Article
Diagnosis Assistance in Colposcopy by Segmenting Acetowhite Epithelium Using U-Net with Images before and after Acetic Acid Solution Application
by Toshihiro Shinohara, Kosuke Murakami and Noriomi Matsumura
Diagnostics 2023, 13(9), 1596; https://doi.org/10.3390/diagnostics13091596 - 29 Apr 2023
Cited by 5 | Viewed by 4307
Abstract
Colposcopy is an essential examination tool to identify cervical intraepithelial neoplasia (CIN), a precancerous lesion of the uterine cervix, and to sample its tissues for histological examination. In colposcopy, gynecologists visually identify the lesion highlighted by applying an acetic acid solution to the [...] Read more.
Colposcopy is an essential examination tool to identify cervical intraepithelial neoplasia (CIN), a precancerous lesion of the uterine cervix, and to sample its tissues for histological examination. In colposcopy, gynecologists visually identify the lesion highlighted by applying an acetic acid solution to the cervix using a magnifying glass. This paper proposes a deep learning method to aid the colposcopic diagnosis of CIN by segmenting lesions. In this method, to segment the lesion effectively, the colposcopic images taken before acetic acid solution application were input to the deep learning network, U-Net, for lesion segmentation with the images taken following acetic acid solution application. We conducted experiments using 30 actual colposcopic images of acetowhite epithelium, one of the representative types of CIN. As a result, it was confirmed that accuracy, precision, and F1 scores, which were 0.894, 0.837, and 0.834, respectively, were significantly better when images taken before and after acetic acid solution application were used than when only images taken after acetic acid solution application were used (0.882, 0.823, and 0.823, respectively). This result indicates that the image taken before acetic acid solution application is helpful for accurately segmenting the CIN in deep learning. Full article
(This article belongs to the Special Issue Diagnosis and Management of Uterine Lesions)
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12 pages, 1677 KiB  
Article
Development of an Algorithm to Differentiate Uterine Sarcoma from Fibroids Using MRI and LDH Levels
by Ayako Suzuki, Aki Kido, Mitsuru Matsuki, Yasushi Kotani, Kosuke Murakami, Yukio Yamanishi, Isao Numoto, Hidekatsu Nakai, Tomoyuki Otani, Ikuo Konishi, Masaki Mandai and Noriomi Matsumura
Diagnostics 2023, 13(8), 1404; https://doi.org/10.3390/diagnostics13081404 - 12 Apr 2023
Cited by 2 | Viewed by 2962
Abstract
Background: This study aimed to establish an evaluation method for detecting uterine sarcoma with 100% sensitivity using MRI and serum LDH levels. Methods: One evaluator reviewed the MRI images and LDH values of a total of 1801 cases, including 36 cases of uterine [...] Read more.
Background: This study aimed to establish an evaluation method for detecting uterine sarcoma with 100% sensitivity using MRI and serum LDH levels. Methods: One evaluator reviewed the MRI images and LDH values of a total of 1801 cases, including 36 cases of uterine sarcoma and 1765 cases of uterine fibroids. The reproducibility of the algorithm was also examined by four evaluators with different imaging experience and abilities, using a test set of 61 cases, including 14 cases of uterine sarcoma. Results: From the MRI images and LDH values of 1801 cases of uterine sarcoma and uterine fibroids, we found that all sarcomas were included in the group with a high T2WI and either a high T1WI, an unclear margin, or high LDH values. In addition, when cases with DWI were examined, all sarcomas had high DWI. Among the 36 sarcoma cases, the group with positive findings for T2WI, T1WI, margins, and serum LDH levels all had a poor prognosis (p = 0.015). The reproducibility of the algorithm was examined by four evaluators and the sensitivity of sarcoma detection ranged from 71% to 93%. Conclusion: We established an algorithm to distinguish uterine sarcoma if tumors in the myometrium with low T2WI and DWI are present. Full article
(This article belongs to the Special Issue Diagnosis and Management of Uterine Lesions)
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Review

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17 pages, 10539 KiB  
Review
Uterine Tumor Resembling Ovarian Sex-Cord Tumor (UTROSCT): A Rare Polyphenotypic Neoplasm
by Giovanna Giordano, Debora Guareschi and Elena Thai
Diagnostics 2024, 14(12), 1271; https://doi.org/10.3390/diagnostics14121271 - 17 Jun 2024
Viewed by 1338
Abstract
Uterine tumor resembling ovarian sex-cord tumor (UTROSCT) is a rare form of uterine mesenchymal neoplasm. Although UTROSCT generally exhibits benign behavior with a favorable prognosis, this neoplasm is nevertheless classified as being of uncertain malignant potential, given its low rate of recurrence and [...] Read more.
Uterine tumor resembling ovarian sex-cord tumor (UTROSCT) is a rare form of uterine mesenchymal neoplasm. Although UTROSCT generally exhibits benign behavior with a favorable prognosis, this neoplasm is nevertheless classified as being of uncertain malignant potential, given its low rate of recurrence and the fact that it rarely produces metastases (e.g., in the lymph nodes, epiploic appendix, omentum, small bowel, subcutaneous tissue, lungs). Its histogenesis is also uncertain. Typically, UTROSCT occurs in peri-menopausal or menopausal women, but it can sometimes be observed in young women. Usually, this neoplasm can be found in the uterine corpus as a nodular intramural lesion, while it is less frequently submucosal, subserosal, or polypoid/intracavitary. UTROSCT can cause abnormal bleeding, pelvic pain, enlarged uterus, and mass sensation, but sometimes it is found purely by chance. This neoplasm can be considered polyphenotypic on morphological, immunohistochemical, and genetic analyses. Generally, upon microscopic examination, UTROSCT shows a predominant pattern of the cords, nests, and trabeculae typical of sex-cord tumors of the ovary, while immunohistochemically it is characterized by a coexpression of epithelial, smooth muscle, and sex-cord markers. The aim of this review is to report clinical and pathological data and genetic alterations to establish their impact on the prognosis and management of patients affected by this rare entity. Full article
(This article belongs to the Special Issue Diagnosis and Management of Uterine Lesions)
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Other

Jump to: Research, Review

10 pages, 1512 KiB  
Brief Report
MRI-Based Risk Factors for Adverse Maternal Outcomes in Prophylactic Aortic Balloon Occlusion for Placenta Accreta Spectrum and Placenta Previa
by Hiroyuki Tokue, Masashi Ebara, Takayuki Yokota, Hiroyuki Yasui, Azusa Tokue and Yoshito Tsushima
Diagnostics 2024, 14(3), 333; https://doi.org/10.3390/diagnostics14030333 - 4 Feb 2024
Viewed by 1702
Abstract
Purpose: We previously reported that T2 dark bands and placental bulges observed in magnetic resonance imaging (MRI) can predict adverse maternal outcomes in patients with placenta accreta spectrum (PAS) and placenta previa undergoing prophylactic balloon occlusion of the internal iliac artery. On the [...] Read more.
Purpose: We previously reported that T2 dark bands and placental bulges observed in magnetic resonance imaging (MRI) can predict adverse maternal outcomes in patients with placenta accreta spectrum (PAS) and placenta previa undergoing prophylactic balloon occlusion of the internal iliac artery. On the other hand, the risk factors associated with the use of prophylactic aortic balloon occlusion (PABO) have not been sufficiently investigated. This retrospective study aimed to identify MRI-based risk factors associated with adverse maternal outcomes in the context of PABO during a cesarean section (CS) for PAS and placenta previa. Materials and Methods: Ethical approval was obtained for a data analysis of 40 patients diagnosed with PAS and placenta previa undergoing PABO during a CS. Clinical records, MRI features, and procedural details were examined. The inclusion criteria for the massive bleeding group were as follows: an estimated blood loss (EBL) > 2500 mL, packed red blood cell (pRBC) transfusion (>4 units), and the need for a hysterectomy or transcatheter arterial embolization after delivery. The massive and nonmassive bleeding groups were compared. Results: Among the 22 patients, those in the massive bleeding group showed significantly longer operative durations, a higher EBL (p < 0.001), an increased number of pRBC transfusions (p < 0.001), and prolonged postoperative hospital stays (p < 0.05). T2 dark bands on MRI were significant predictors of adverse outcomes (p < 0.05). Conclusion: T2 dark bands on MRI were crucial predictors of adverse maternal outcomes in patients undergoing PABO for PAS or placenta previa during a CS. Recognizing these MRI features proactively indicates the need for effective management strategies during childbirth and emphasizes the importance of further prospective studies to validate and enhance these findings. Full article
(This article belongs to the Special Issue Diagnosis and Management of Uterine Lesions)
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22 pages, 1368 KiB  
Systematic Review
Sonographic and Magnetic Resonance Characteristics of Gynecological Sarcoma
by Carolina Camponovo, Stephanie Neumann, Livia Zosso, Michael D. Mueller and Luigi Raio
Diagnostics 2023, 13(7), 1223; https://doi.org/10.3390/diagnostics13071223 - 23 Mar 2023
Cited by 7 | Viewed by 2295
Abstract
Introduction: Gynecological sarcomas are rare malignant tumors with an incidence of 1.5–3/100,000 and are 3–9% of all malignant uterine tumors. The preoperative differentiation between sarcoma and myoma becomes increasingly important with the development of minimally invasive treatments for myomas, as this means undertreatment [...] Read more.
Introduction: Gynecological sarcomas are rare malignant tumors with an incidence of 1.5–3/100,000 and are 3–9% of all malignant uterine tumors. The preoperative differentiation between sarcoma and myoma becomes increasingly important with the development of minimally invasive treatments for myomas, as this means undertreatment for sarcoma. There are currently no reliable laboratory tests or imaging-characteristics to detect sarcomas. The objective of this article is to gain an overview of sarcoma US/MRI characteristics and assess their accuracy for preoperative diagnosis. Methods: A systematic literature review was performed and 12 studies on ultrasound and 21 studies on MRI were included. Results: For the ultrasound, these key features were gathered: solid tumor > 8 cm, unsharp borders, heterogeneous echogenicity, no acoustic shadowing, rich vascularization, and cystic changes within. For the MRI, these key features were gathered: irregular borders; heterogeneous; high signal on T2WI intensity; and hemorrhagic and necrotic changes, with central non-enhancement, hyperintensity on DWI, and low values for ADC. Conclusions: These features are supported by the current literature. In retrospective analyses, the ultrasound did not show a sufficient accuracy for diagnosing sarcoma preoperatively and could also not differentiate between the different subtypes. The MRI showed mixed results: various studies achieved high sensitivities in their analysis, when combining multiple characteristics. Overall, these findings need further verification in prospective studies with larger study populations. Full article
(This article belongs to the Special Issue Diagnosis and Management of Uterine Lesions)
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