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

Objective To assess the prevalence of sonographic signs in women with uterine sarcoma. Materials and Methods A systematic review and meta-analysis were performed. Five electronic databases were searched from inception to June 2022 for all studies allowing calculation of the prevalence of sonographic signs in women with uterine sarcoma. 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. The 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. Conclusion Solid component, irregular walls of cystic areas, and singular lesions are signs with very high prevalence, while inhomogeneous echogenicity of solid component, anechoic cystic areas, and absence of calcifications are signs with high prevalence. The remaining signs were less relevant.