Evaluation of myometrial invasion in endometrial cancer: comparison of diffusion-weighted magnetic resonance and intraoperative frozen sections

Abstract

In assessing the depth of myometrial invasion, ADC maps show the same accuracy as intraoperative histological studies in endometrial cancers. They also allow for a more precise assessment than conventional MRI sequences. Frozen-section analysis can be avoided if the preoperative MRI study includes DWI sequences and ADC maps.

Risk Factors of Lymph Node Metastases with Endometrial Carcinoma

“…Several techniques can be used for the preoperative assessment disease invasion. Magnetic resonance imaging (MRI) has a sensitivity of 57.9% in determining deep myometrial invasion, and an accuracy of 80.4% (Gallego et al, 2014). In another study, sensitivity, specificity, NPV, PPV and accuracy for diagnosing deep MI were 69.0%, 93.1%, 91.3%, 74.1%, and 87.8%, respectively, for MRI (Hahn et al, 2013).…”

“…Sensitivity, specificity, NPV, PPV and accuracy for diagnosing deep MI were 85.7%, 96.8%, 95.8%, 88.9%, and 94.3% for intraoperative frozen section (IFS) (Hahn et al, 2013). In another study the accuracy, sensitivity, specificity, PPV, and NPV for detecting deep invasion of the myometrium were 90.2%, 73.7%, 100%, 100%, and 86.5%, respectively (Gallego et al, 2014).…”

Preoperative MRI and Intraoperative Frozen Section Diagnosis of Myometrial Invasion in Patients With Endometrial Cancer

“…21,24 However, some physicians suggest that MRI with diffusion-weighted imaging has the same accuracy as intraoperative FSs. 22 Furthermore, none of the patients identified as low-risk by both MRI and FSs had pelvic or para-aortic lymph node metastasis in the final pathology. 23 The evaluation of the tumor grade by FSs has been reported to have a sensitivity of 40% to 98%, a specificity of 53% to 98%, and an accuracy of 83% to 89%.…”

Preoperative Assessment of Myometrial Invasion in Endometrial Cancer by 3D Ultrasound and Diffusion-Weighted Magnetic Resonance Imaging

“…In the study by Hori et al, 22 2 different observers prospectively estimated the myometrial invasion using DW-MRI in a total of 71 patients, showing a good accuracy (87% and 92%), sensitivity (95% and 84%), and specificity (85% and 94%). Gallego et al, 20 in a comparative study, reported an accuracy, sensitivity, and specificity of 90.2%, 77.8%, and 97% respectively, for DW-MRI. Our data are in line with the meta-analyses by Andreano et al 28 who reported a sensitivity and a specificity of 86%, considering 9 studies with a total of 442 patients.…”