Endometrial cancer: Preoperative versus intraoperative staging

Rei, Mariana; Rodrigues, Inês Morais; Condeço, Pedro; Igreja, Fernando; Veríssimo, Carlos; Mendinhos, Gustavo

doi:10.1016/j.jogoh.2019.101647

Cited by 10 publications

(31 citation statements)

References 15 publications

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“…reported a sensitivity of 70% (95% CI, 64–75%) and a specificity of 80% (95% CI, 76–82%). We observed lower sensitivity of MRI for DMI compared with that reported in previous studies (Table 3), as well as compared with that observed for TVS in our study, although the difference was not significant (51% (95% CI, 36–66%) for MRI vs 69% (95% CI, 53–82%) for TVS) 6,9–17 . These differences might be explained by the fact that we included only low‐grade EECs or because MRI was evaluated by a team of three radiologists, which might impact on inter‐rater reliability.…”

Section: Discussioncontrasting

confidence: 63%

See 1 more Smart Citation

Diagnostic performance of transvaginal ultrasound and magnetic resonance imaging for preoperative evaluation of low‐grade endometrioid endometrial carcinoma: prospective comparative study

Cubo-Abert

Díaz-Feijoó

Bradbury

et al. 2021

Ultrasound in Obstet & Gyne

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In a prospective and consecutive study, we have demonstrated that the diagnostic performance of transvaginal ultrasound (TVS) is similar to that of magnetic resonance imaging for the prediction of deep myometrial invasion and cervical stromal involvement in low-grade (Grade 1 or 2) endometrioid endometrial cancer. What are the clinical implications of this work?TVS can play a role as a first-line imaging technique in the preoperative evaluation of low-grade endometrioid endometrial cancer, and its use could avoid unnecessary lymphadenectomy being performed at the time of surgery.

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Section: Discussioncontrasting

confidence: 63%

“…Several studies have evaluated the diagnostic performance of TVS and MRI in the detection of deep myometrial invasion (DMI) and CSI in EC 6,[9][10][11][12][13][14][15][16][17] . However, they included all EC diagnoses irrespective of the histological type and stage.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic performance of transvaginal ultrasound and magnetic resonance imaging for preoperative evaluation of low‐grade endometrioid endometrial carcinoma: prospective comparative study

Cubo-Abert

Díaz-Feijoó

Bradbury

et al. 2021

Ultrasound in Obstet & Gyne

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“…To our knowledge, 11 studies directly compared the diagnostic performance of MRI and FS in predicting deep MI using both methods in the same subjects. [13][14][15][16][17][18][19][20][21][22][23] We compared MRI/FS data between our current study and these previous studies, and conducted a pooled analysis of these data (Figure 2). The diagnostic performance of MRI varies more widely among studies compared with that of FS, suggesting that the differences in MRI technology or the skills of the radiologists may strongly affect the diagnostic performance of MRI.…”

Section: Discussionmentioning

confidence: 99%

“…The diagnostic performance data of MRI and frozen section (FS) diagnosis in detecting deep myometrial invasion were pooled from 12 studies directly comparing both methods in the same patients. [13][14][15][16][17][18][19][20][21][22][23] Forest plot shows the sensitivity, specificity, and accuracy of MRI ( ) and FS reports ( ) with corresponding 95% confidence intervals in individual studies and the pooled analysis. The dotted lines indicate the pooled sensitivity, specificity, and accuracy of FS diagnosis.…”

Section: Comparison Of Mri Findings and Fs Diagnosismentioning

confidence: 99%

“…We also examined the diagnostic performance of combining MRI and FS results, which were classified into four groups (MRI+/FS+, MRI+/FS-, MRI-/FS+, and MRI-/FS-). We compared our data with those from 11 studies reporting direct comparisons between MRI and FS by using both methods in a single study [13][14][15][16][17][18][19][20][21][22][23]. These relevant articles were identified from the National Library of Medicine (PubMed) database.…”

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confidence: 99%

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Preoperative Magnetic Resonance Imaging versus Intraoperative Frozen Section Diagnosis for Predicting the Deep Myometrial Invasion in Endometrial Cancer: Our Experience and Literature Review

Iitsuka

Asami

Hirose

et al. 2021

J of Obstet and Gynaecol

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Aim: The present study was designed to directly compare the diagnostic performance of preoperative magnetic resonance imaging (MRI) and intraoperative frozen section (FS) diagnoses in predicting deep myometrial invasion (MI) of endometrial cancer. Methods: Using MRI findings and FS diagnoses, 194 patients with surgically staged endometrial cancer were evaluated for deep MI between 2006 and 2018. Definitive histological diagnosis of paraffin sections of excised tissues was used as the gold standard approach. Results: Of 194 cases, 53 (27.3%) cases were finally diagnosed as having deep MI (≥50%). There was 82% total agreement between MRI and FS diagnoses in predicting deep MI, with a kappa value of 0.54 (95% confidence interval [CI] = 0.40-0.67, moderate agreement). The sensitivity of FS diagnosis (0.66, 95% CI = 0.52-0.78) for predicting deep MI was lower than that of MRI (0.77, 95% CI = 0.63-0.87; p = 0.21), while the specificity of FS (0.98, 95% CI = 0.93-0.99) was significantly higher than that of MRI (0.88, 95% CI = 0.81-0.93; p = 0.001). Overall, the accuracy of FS (0.89, 95% CI = 0.84-0.93) was higher than that of MRI (0.85, 95% CI = 0.79-0.90), although the difference did not reach statistical significance (p = 0.23). The accuracy (0.95, 95% CI = 0.90-0.97) was very high in cases with concordant MRI and FS results. Conclusions: MRI and FS showed different diagnostic characteristics for predicting deep MI, with a higher specificity observed for FS and the greatest accuracy obtained in concordant cases. Thus, our findings recommend the addition of FS diagnosis, either alone or in conjunction with MRI, to MI evaluation.

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Evaluation of the role of intraoperative frozen section and magnetic resonance imaging in endometrial cancer

Ooka

Nanki

Yamagami

et al. 2022

Intl J Gynecology & Obste

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Endometrial cancer is one of the most common types of gynecologic cancer. The major prognostic factors of endometrial carcinoma include FIGO (International Federation of Gynecology & Obstetrics) staging, myometrial invasion, and histologic type and grade. 1Although total hysterectomy and bilateral salpingo-oophorectomy are the reference standard procedures for surgical staging, lymphadenectomy is required when the case is considered as high-risk for post-surgical recurrence.

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Endometrial cancer: Preoperative versus intraoperative staging

Cited by 10 publications

References 15 publications

Diagnostic performance of transvaginal ultrasound and magnetic resonance imaging for preoperative evaluation of low‐grade endometrioid endometrial carcinoma: prospective comparative study

Diagnostic performance of transvaginal ultrasound and magnetic resonance imaging for preoperative evaluation of low‐grade endometrioid endometrial carcinoma: prospective comparative study

Preoperative Magnetic Resonance Imaging versus Intraoperative Frozen Section Diagnosis for Predicting the Deep Myometrial Invasion in Endometrial Cancer: Our Experience and Literature Review

Evaluation of the role of intraoperative frozen section and magnetic resonance imaging in endometrial cancer

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