open access

Vol 90, No 3 (2019)
ORIGINAL PAPERS Gynecology
Published online: 2019-03-29
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Can preoperative magnetic resonance imaging replace intraoperative frozen sectioning in the evaluation of myometrial invasion for early-stage endometrial carcinoma?

Volkan Karataşlı, İlker Çakır, Hilal Şahin, Duygu Ayaz, Muzaffer Sancı
DOI: 10.5603/GP.2019.0023
·
Pubmed: 30950001
·
Ginekol Pol 2019;90(3):128-133.

open access

Vol 90, No 3 (2019)
ORIGINAL PAPERS Gynecology
Published online: 2019-03-29

Abstract

Objectives: To examine the performance of preoperative magnetic resonance imaging (MRI) and intraoperative frozen sectioning in the assessment of myometrial invasion during the early stages of endometrial cancer. 

Material and methods: This retrospective study employed data from patients with endometrial cancer who were operated on between January 2013 and November 2018. Patients who underwent preoperative MRI and were of FIGO 2009 stage I were included in the study. Radiological staging and intraoperative staging by frozen sectioning were carried out. The data were analyzed to assess agreement of the overall results concerning myometrial invasion. 

Results: In total, 222 patients were enrolled. Their mean age was 58.3 ± 8.5 years. The accuracy of MRI for the detection of myometrial invasion was 88.7% and its sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 91.6%, 82.1%, 92.2%, and 80.9%, respectively, with a kappa coefficient of 0.734 (95% confidence interval [CI], 0.684–0.784; p < 0.001). The accuracy of intraoperative frozen sectioning was 94.4%, and its sensitivity, specificity, PPV, and NPV were 97.7%, 85.7%, 94.7%, and 93.4%, respectively, with a kappa coefficient of 0.856 (95% CI, 0.812–0.900; p < 0.001). No significant difference in accuracy was observed between MRI and frozen sectioning (p = 0.057). MRI and frozen sectioning were sensitive for the detection of myometrial invasion, according to receiver operating curve analyses (areas under the curve, 0.869 and 0.917, respectively; p < 0.001). 

Conclusions: The assessment of myometrial invasion by preoperative MRI and intraoperative frozen sectioning during the early stages of endometrial carcinoma was highly accurate. 

Abstract

Objectives: To examine the performance of preoperative magnetic resonance imaging (MRI) and intraoperative frozen sectioning in the assessment of myometrial invasion during the early stages of endometrial cancer. 

Material and methods: This retrospective study employed data from patients with endometrial cancer who were operated on between January 2013 and November 2018. Patients who underwent preoperative MRI and were of FIGO 2009 stage I were included in the study. Radiological staging and intraoperative staging by frozen sectioning were carried out. The data were analyzed to assess agreement of the overall results concerning myometrial invasion. 

Results: In total, 222 patients were enrolled. Their mean age was 58.3 ± 8.5 years. The accuracy of MRI for the detection of myometrial invasion was 88.7% and its sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 91.6%, 82.1%, 92.2%, and 80.9%, respectively, with a kappa coefficient of 0.734 (95% confidence interval [CI], 0.684–0.784; p < 0.001). The accuracy of intraoperative frozen sectioning was 94.4%, and its sensitivity, specificity, PPV, and NPV were 97.7%, 85.7%, 94.7%, and 93.4%, respectively, with a kappa coefficient of 0.856 (95% CI, 0.812–0.900; p < 0.001). No significant difference in accuracy was observed between MRI and frozen sectioning (p = 0.057). MRI and frozen sectioning were sensitive for the detection of myometrial invasion, according to receiver operating curve analyses (areas under the curve, 0.869 and 0.917, respectively; p < 0.001). 

Conclusions: The assessment of myometrial invasion by preoperative MRI and intraoperative frozen sectioning during the early stages of endometrial carcinoma was highly accurate. 

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Keywords

endometrial cancer; myometrial invasion; magnetic resonance imaging; MRI; frozen sectioning

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About this article
Title

Can preoperative magnetic resonance imaging replace intraoperative frozen sectioning in the evaluation of myometrial invasion for early-stage endometrial carcinoma?

Journal

Ginekologia Polska

Issue

Vol 90, No 3 (2019)

Pages

128-133

Published online

2019-03-29

DOI

10.5603/GP.2019.0023

Pubmed

30950001

Bibliographic record

Ginekol Pol 2019;90(3):128-133.

Keywords

endometrial cancer
myometrial invasion
magnetic resonance imaging
MRI
frozen sectioning

Authors

Volkan Karataşlı
İlker Çakır
Hilal Şahin
Duygu Ayaz
Muzaffer Sancı

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