Correlation Between MRI, Frozen Section and Histopathological Findings In Carcinoma Endometrium

Introduction: Endometrial carcinoma is the most common pelvic gynecological malignancy in industrialized countries and the incidence is increasing.Treatment and prognosis depends on a number of factors, including stage, depth of myometrial invasion, cervical extension, lymphovascular invasion, histologic grade and nodal status. Deep (more than 50%) myometrial infiltration is an indication for pelvic and para aortic nodal dissection as an adjunct to hysterectomy and salpingo-opherectomy. Lymphadenectomy for early stage (stage 1) endometrial cancer remains controversial. Aims and Objectives: To correlate between preoperative MRI, intraoperative Frozen section and postoperative Histopathological findings based on 3 parameters; depth of myometrial invasion, cervical involvement and lymph nodes. Materials and Methods: This prospective study was carried out in the department of Obstetrics and Gynaecology at Kokilaben Dhirubhai Ambani Hospital, Mumbai from March 2013 to March 2014 after approval of the Ethics Committee. Study included 50 patients who were diagnosed with Endometrial Cancer and have undergone surgery here. Only operable patients were included. Study period: March 2013 to March 2014 Conclusion: The present study shows that there is significant correlation between MRI, Frozen Section and Histopathological findings i.e., myometrial invasion, cervical invasion and lymph node in a patient of Carcinoma of the Endometrium. MRI can accurately assess myometrial invasion and cervical infiltration. MRI is also an important predictor of lymph node metastasis and when combined with Frozen section findings could be used to select patients at low risk of recurrence. This information allows the selection of patients for pelvic or paraaortic lymph node sampling while obviating radical surgery in patients with low risk of recurrent disease or significant comorbidities. It also helps in planning postoperative adjuvant therapy.