Preliminary observations and clinical value of lipid peak in high-grade uterine sarcomas using in vivo proton MR spectroscopy

Abstract

To retrospectively evaluate the clinical significance of the lipid peak in in vivo proton magnetic resonance spectroscopy (MRS) for the diagnosis of high-grade uterine sarcomas. MRS was performed in patients with 38 pathologically diagnosed uterine corpus tumours (26 leiomyomas and 12 sarcomas) at 3T. Single-voxel MRS data were collected from a single square volume of interest that encompassed the tumours. The concentrations of lipid and total choline compounds (tCho) were classified as high, low or none. High lipid peaks were observed in all 12 sarcomas and not in benign leiomyomas except for 1 lipoleiomyoma. All 26 leiomyomas and 10 of the 12 sarcomas showed tCho peaks, whereas 2 sarcomas with massive necrosis showed no tCho peak. The presence of a high lipid peak for the diagnosis of sarcoma had a sensitivity of 100%, specificity of 96%, positive predictive value of 92% and negative predictive value of 100%. The high lipid peaks in high-grade malignant tumours may be observed in both viable and necrotic areas, and may be useful in distinguishing uterine sarcomas from benign leiomyomas. • High lipid peak on MR spectroscopy is suggestive of uterine sarcomas. • Lipid peak is observed in both viable and necrotic areas in sarcomas. • MR spectroscopy may be useful in distinguishing uterine sarcomas from benign leiomyomas.