Preoperative and intraoperative assessment of myometrial invasion in endometrial cancer

Comparison of magnetic resonance imaging and frozen sections

Iori Kisu, Kouji Banno, Li Yu Lin, Akihisa Ueno, Takayuki Abe, Keisuke Koyama, Shigeo Okuda, Yohei Masugi, Kiyoko Umene, Yuya Nogami, Kosuke Tsuji, Kenta Masuda, Arisa Ueki, Yusuke Kobayashi, Wataru Yamagami, Nobuyuki Susumu, Daisuke Aoki

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16 Citations (Scopus)

Abstract

Objective To compare the diagnostic characteristics of the evaluation of myometrial invasion (MI) retrospectively between preoperative magnetic resonance imaging (MRI) and intraoperative frozen sections. Design A retrospective study. Setting University hospital. Sample 201 women diagnosed with endometrial carcinoma. Methods All women underwent preoperative MRI and 111 of them also underwent intraoperative frozen section assessment. The final pathological evaluation was used as the definitive diagnosis. Main outcome measures In women who underwent MRI and frozen sections (n = 111), the accuracies of detection of MI and of deep invasion (defined as ≥50% invasion) were compared. Results The accuracy, sensitivity, and specificity of MRI for detection of MI were 65.8, 58.8, and 88.5%, and those in frozen sections were 90.1, 90.6, and 88.5%, respectively. The accuracy and sensitivity of frozen sections were significantly higher (p < 0.001, p < 0.001), whereas the specificity of the two methods did not differ (p = 1.000). The accuracy, sensitivity, and specificity of MRI for detection of deep invasion were 83.8, 69.2, and 88.2%, and those of frozen sections were 93.7, 73.1, and 100.0%, respectively. The accuracy and specificity of frozen sections were significantly higher (p = 0.007 and p < 0.001, respectively), whereas sensitivity did not show a significant difference (p = 0.999). Conclusion In assessment of MI, the accuracy of frozen sections was significantly higher than that of MRI. Since the diagnostic characteristics differ between two methods, additional intraoperative frozen sections are recommended for more accurate assessment of MI when MRI is negative for the presence of any MI or positive for the presence of deep invasion.

Original languageEnglish
Pages (from-to)525-535
Number of pages11
JournalActa Obstetricia et Gynecologica Scandinavica
Volume92
Issue number5
DOIs
Publication statusPublished - 2013 May

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Frozen Sections
Endometrial Neoplasms
Magnetic Resonance Imaging
Sensitivity and Specificity
Retrospective Studies
Outcome Assessment (Health Care)

Keywords

  • Endometrial cancer
  • frozen section
  • magnetic resonance imaging
  • myometrial invasion
  • sensitivity
  • specificity

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

@article{ec82ca8967cb42e983d354360d9b9d02,
title = "Preoperative and intraoperative assessment of myometrial invasion in endometrial cancer: Comparison of magnetic resonance imaging and frozen sections",
abstract = "Objective To compare the diagnostic characteristics of the evaluation of myometrial invasion (MI) retrospectively between preoperative magnetic resonance imaging (MRI) and intraoperative frozen sections. Design A retrospective study. Setting University hospital. Sample 201 women diagnosed with endometrial carcinoma. Methods All women underwent preoperative MRI and 111 of them also underwent intraoperative frozen section assessment. The final pathological evaluation was used as the definitive diagnosis. Main outcome measures In women who underwent MRI and frozen sections (n = 111), the accuracies of detection of MI and of deep invasion (defined as ≥50{\%} invasion) were compared. Results The accuracy, sensitivity, and specificity of MRI for detection of MI were 65.8, 58.8, and 88.5{\%}, and those in frozen sections were 90.1, 90.6, and 88.5{\%}, respectively. The accuracy and sensitivity of frozen sections were significantly higher (p < 0.001, p < 0.001), whereas the specificity of the two methods did not differ (p = 1.000). The accuracy, sensitivity, and specificity of MRI for detection of deep invasion were 83.8, 69.2, and 88.2{\%}, and those of frozen sections were 93.7, 73.1, and 100.0{\%}, respectively. The accuracy and specificity of frozen sections were significantly higher (p = 0.007 and p < 0.001, respectively), whereas sensitivity did not show a significant difference (p = 0.999). Conclusion In assessment of MI, the accuracy of frozen sections was significantly higher than that of MRI. Since the diagnostic characteristics differ between two methods, additional intraoperative frozen sections are recommended for more accurate assessment of MI when MRI is negative for the presence of any MI or positive for the presence of deep invasion.",
keywords = "Endometrial cancer, frozen section, magnetic resonance imaging, myometrial invasion, sensitivity, specificity",
author = "Iori Kisu and Kouji Banno and Lin, {Li Yu} and Akihisa Ueno and Takayuki Abe and Keisuke Koyama and Shigeo Okuda and Yohei Masugi and Kiyoko Umene and Yuya Nogami and Kosuke Tsuji and Kenta Masuda and Arisa Ueki and Yusuke Kobayashi and Wataru Yamagami and Nobuyuki Susumu and Daisuke Aoki",
year = "2013",
month = "5",
doi = "10.1111/aogs.12048",
language = "English",
volume = "92",
pages = "525--535",
journal = "Acta Obstetricia et Gynecologica Scandinavica",
issn = "0001-6349",
publisher = "Wiley-Blackwell",
number = "5",

}

TY - JOUR

T1 - Preoperative and intraoperative assessment of myometrial invasion in endometrial cancer

T2 - Comparison of magnetic resonance imaging and frozen sections

AU - Kisu, Iori

AU - Banno, Kouji

AU - Lin, Li Yu

AU - Ueno, Akihisa

AU - Abe, Takayuki

AU - Koyama, Keisuke

AU - Okuda, Shigeo

AU - Masugi, Yohei

AU - Umene, Kiyoko

AU - Nogami, Yuya

AU - Tsuji, Kosuke

AU - Masuda, Kenta

AU - Ueki, Arisa

AU - Kobayashi, Yusuke

AU - Yamagami, Wataru

AU - Susumu, Nobuyuki

AU - Aoki, Daisuke

PY - 2013/5

Y1 - 2013/5

N2 - Objective To compare the diagnostic characteristics of the evaluation of myometrial invasion (MI) retrospectively between preoperative magnetic resonance imaging (MRI) and intraoperative frozen sections. Design A retrospective study. Setting University hospital. Sample 201 women diagnosed with endometrial carcinoma. Methods All women underwent preoperative MRI and 111 of them also underwent intraoperative frozen section assessment. The final pathological evaluation was used as the definitive diagnosis. Main outcome measures In women who underwent MRI and frozen sections (n = 111), the accuracies of detection of MI and of deep invasion (defined as ≥50% invasion) were compared. Results The accuracy, sensitivity, and specificity of MRI for detection of MI were 65.8, 58.8, and 88.5%, and those in frozen sections were 90.1, 90.6, and 88.5%, respectively. The accuracy and sensitivity of frozen sections were significantly higher (p < 0.001, p < 0.001), whereas the specificity of the two methods did not differ (p = 1.000). The accuracy, sensitivity, and specificity of MRI for detection of deep invasion were 83.8, 69.2, and 88.2%, and those of frozen sections were 93.7, 73.1, and 100.0%, respectively. The accuracy and specificity of frozen sections were significantly higher (p = 0.007 and p < 0.001, respectively), whereas sensitivity did not show a significant difference (p = 0.999). Conclusion In assessment of MI, the accuracy of frozen sections was significantly higher than that of MRI. Since the diagnostic characteristics differ between two methods, additional intraoperative frozen sections are recommended for more accurate assessment of MI when MRI is negative for the presence of any MI or positive for the presence of deep invasion.

AB - Objective To compare the diagnostic characteristics of the evaluation of myometrial invasion (MI) retrospectively between preoperative magnetic resonance imaging (MRI) and intraoperative frozen sections. Design A retrospective study. Setting University hospital. Sample 201 women diagnosed with endometrial carcinoma. Methods All women underwent preoperative MRI and 111 of them also underwent intraoperative frozen section assessment. The final pathological evaluation was used as the definitive diagnosis. Main outcome measures In women who underwent MRI and frozen sections (n = 111), the accuracies of detection of MI and of deep invasion (defined as ≥50% invasion) were compared. Results The accuracy, sensitivity, and specificity of MRI for detection of MI were 65.8, 58.8, and 88.5%, and those in frozen sections were 90.1, 90.6, and 88.5%, respectively. The accuracy and sensitivity of frozen sections were significantly higher (p < 0.001, p < 0.001), whereas the specificity of the two methods did not differ (p = 1.000). The accuracy, sensitivity, and specificity of MRI for detection of deep invasion were 83.8, 69.2, and 88.2%, and those of frozen sections were 93.7, 73.1, and 100.0%, respectively. The accuracy and specificity of frozen sections were significantly higher (p = 0.007 and p < 0.001, respectively), whereas sensitivity did not show a significant difference (p = 0.999). Conclusion In assessment of MI, the accuracy of frozen sections was significantly higher than that of MRI. Since the diagnostic characteristics differ between two methods, additional intraoperative frozen sections are recommended for more accurate assessment of MI when MRI is negative for the presence of any MI or positive for the presence of deep invasion.

KW - Endometrial cancer

KW - frozen section

KW - magnetic resonance imaging

KW - myometrial invasion

KW - sensitivity

KW - specificity

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