Prevalence of sonographic signs in women with uterine sarcoma: a systematic review and meta-analysis

Objective:To assess the prevalence of sonographic signs in uterine sarcomas women. Materials and Methods:A systematic review and meta-analysis was performed searching 5 electronic databases from inception to June 2022 for all studies that allowed to calculate the prevalence of sonographic signs in uterine sarcomas women. Pooled prevalence with 95% confidence intervals was calculated for each sonographic sign and was a priori defined as very high when it was ≥ 80%, high when it ranged from 80% to 70%, and less relevant when it was ≤ 70%. Results:6 studies with 317 sarcoma patients were included. Pooled prevalence was: 25.0%(95%CI:15.4-37.9%) for absence of visibility of the myometrium; 80.5%(95%CI:74.8-85.2%) for solid component; 78.3%(95%CI:59.3-89.9%) for inhomogeneous echogenicity of solid component; 47.9%(95%CI:41.1-54.8%) for cystic areas; 80.7%(95%CI:68.3-89.0%) for irregular walls of cystic areas; 72.3%(95%CI:16.7-97.2%) for anechoic cystic areas; 54.8%(95%CI:34.0-74.1%) for absence of shadowing; 73.5%(95%CI:43.3-90.9%) for absence of calcifications; 48.7%(95%CI:18.6-79.8%) for color score 3 or 4; 47.3%(95%CI:37.0-57.8%) for irregular tumor borders; 45.4%(95%CI:27.6-64.3%) for endometrial cavity not visualizable; 10.9%(95%CI:3.5-29.1%) for free pelvic fluid; 6.4%(95%CI:1.1-30.2%) for ascites; 21.2%(95%CI:2.1-76.8%) for intracavitary process; 81.5%(95%CI:56.1-93.8%) for singular lesion. Conclusions:Solid component, irregular walls of cystic areas and singular lesions are signs at very high prevalence, while inhomogeneous echogenicity of solid component, anechoic cystic areas and absence of calcifications are signs at high prevalence. Remaining signs were less relevant.