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.
  
  
  METHODS
  A retrospective study.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Iori
authors.initials: I
authors.lastname: Kisu
authors.forename: Kouji
authors.initials: K
authors.lastname: Banno
authors.forename: Li-Yu
authors.initials: LY
authors.lastname: Lin
authors.forename: Akihisa
authors.initials: A
authors.lastname: Ueno
authors.forename: Takayuki
authors.initials: T
authors.lastname: Abe
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kouyama
authors.forename: Shigeo
authors.initials: S
authors.lastname: Okuda
authors.forename: Yohei
authors.initials: Y
authors.lastname: Masugi
authors.forename: Kiyoko
authors.initials: K
authors.lastname: Umene
authors.forename: Yuya
authors.initials: Y
authors.lastname: Nogami
authors.forename: Kosuke
authors.initials: K
authors.lastname: Tsuji
authors.forename: Kenta
authors.initials: K
authors.lastname: Masuda
authors.forename: Arisa
authors.initials: A
authors.lastname: Ueki
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Wataru
authors.initials: W
authors.lastname: Yamagami
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Susumu
authors.forename: Daisuke
authors.initials: D
authors.lastname: Aoki
mesh_terms: D000328:Adult; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D005629:Frozen Sections; D006801:Humans; D007432:Intraoperative Period; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009215:Myometrium / Q000473:pathology*; D009361:Neoplasm Invasiveness / Q000175:diagnosis; D057234:Preoperative Period; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity