Classification of uterine sarcoma and leiomyoma with quantitative CT and dual-energy iodine mapping

April 1, 2026Clinical ImagingOpen Access

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Key Points

To determine if quantitative CT metrics can effectively distinguish between uterine sarcomas and leiomyomas preoperatively.
Retrospective analysis of women with histopathologically confirmed leiomyoma or uterine sarcoma undergoing contrast-enhanced abdominopelvic CT.
Computed HU profiles on the slice with the maximum lesion area to analyze intralesional minimum and maximum HU values.
In a DECT subset, assessed normalized iodine concentration (NIC) using defined ROIs for lesions and aorta.
Sarcomas exhibited lower minimum HU and higher HU compared to leiomyomas, both statistically significant (p<0.001).
AUC for minimum HU was 0.75 and for HU was 0.73, indicating fair discriminatory ability.
DECT-derived NIC showed high AUC of 0.96, with a sensitivity of 80% and specificity of 100% in a smaller subset.

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Retrospective analysis evaluates CT metrics and iodine mapping in differentiating uterine tumors, suggesting potential diagnostic improvements.

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Prucker et al. (2026) studied this question.

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