array:24 [ "pii" => "S2173510719300424" "issn" => "21735107" "doi" => "10.1016/j.rxeng.2019.04.003" "estado" => "S300" "fechaPublicacion" => "2019-07-01" "aid" => "1121" "copyright" => "SERAM" "copyrightAnyo" => "2019" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Radiologia. 2019;61:315-23" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S003383381930013X" "issn" => "00338338" "doi" => "10.1016/j.rx.2019.01.007" "estado" => "S300" "fechaPublicacion" => "2019-07-01" "aid" => "1121" "copyright" => "SERAM" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Radiologia. 2019;61:315-23" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 194 "formatos" => array:2 [ "HTML" => 91 "PDF" => 103 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original</span>" "titulo" => "Rédito diagnóstico de la resonancia magnética y el estudio por congelación intraoperatorio en la determinación de la invasión miometrial profunda en cáncer de endometrio" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "315" "paginaFinal" => "323" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Diagnostic yield of magnetic resonance imaging and intraoperative frozen section in the determination of deep myometrial invasion in endometrial cancer" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figura 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1447 "Ancho" => 2029 "Tamanyo" => 261913 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">A) Resonancia magnética (RM) T2 sagital. B) RM T2 axial. C) Estudio intraoperatorio (EIC): pieza macroscópica. D) Anatomía patológica. H/E 400x. Paciente femenina de 68 años, G3P3, en estudio para estadificación inicial de adenocarcinoma de endometrio, subtipo endometrioide y de bajo grado (G1). RM inicial (A y B). Se evidenció una formación tumoral de señal intermedia en T2 (flecha gruesa), restricción en DWI/ADC y realce intenso tras la administración de gadolinio (no se presentan las imágenes de estas dos últimas características) que ocupaba la pared anterior uterina. Impresiona comprometer el miometrio profundo. Se concluyó como M2. Se visualizó un pequeño mioma intramural posterior (flecha fina). EIC (C): se discriminó en el acto quirúrgico el proceso tumoral (flecha gruesa) y el leiomioma posterior (flecha fina). Se concluyó como M1. Anatomía patológica (D): revela la presencia de un adenocarcinoma endometrioide bien diferenciado G1, predominantemente intramucoso, con pequeños focos de invasión inicial del miometrio (flecha gruesa). Se confirmaron los hallazgos de la EIC y RM. En dicho caso, la RM brindó un falso positivo. En un análisis retrospectivo se visualizó que el artefacto por movimiento había llevado a la confusión.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M.F. Sánchez, P.I. Causa Andrieu, C. Latapie, M.C. Saez Perrotta, N. Napoli, M. Perrotta, C.R.B. Chacón, A. Wernicke" "autores" => array:8 [ 0 => array:2 [ "nombre" => "M.F." "apellidos" => "Sánchez" ] 1 => array:2 [ "nombre" => "P.I." "apellidos" => "Causa Andrieu" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Latapie" ] 3 => array:2 [ "nombre" => "M.C." "apellidos" => "Saez Perrotta" ] 4 => array:2 [ "nombre" => "N." "apellidos" => "Napoli" ] 5 => array:2 [ "nombre" => "M." "apellidos" => "Perrotta" ] 6 => array:2 [ "nombre" => "C.R.B." "apellidos" => "Chacón" ] 7 => array:2 [ "nombre" => "A." "apellidos" => "Wernicke" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173510719300424" "doi" => "10.1016/j.rxeng.2019.04.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173510719300424?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S003383381930013X?idApp=UINPBA00004N" "url" => "/00338338/0000006100000004/v4_201910151222/S003383381930013X/v4_201910151222/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2173510719300540" "issn" => "21735107" "doi" => "10.1016/j.rxeng.2019.05.003" "estado" => "S300" "fechaPublicacion" => "2019-07-01" "aid" => "1123" "copyright" => "SERAM" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Radiologia. 2019;61:324-32" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Metastases to the breast, an uncommon diagnosis: What do radiologists need to know?" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "324" "paginaFinal" => "332" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Metástasis en la mama, un diagnóstico infrecuente. ¿Qué deben saber los radiólogos?" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1781 "Ancho" => 3167 "Tamanyo" => 608919 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Case 5. 74-year-old woman diagnosed one year prior with neuroendocrine tumour of the intestine. (A) Left breast mammography with mediolateral oblique and craniocaudal incidence and incidence magnified in the upper outer quadrant (UOQ) where a dense, oval nodule with microlobulated margins is observed (red arrow). (B) Left breast ultrasound of the UOQ where a hypoechoic, oval nodule is observed, solid, with microlobulated margins, with positive Doppler (red arrow). (C) Anatomical pathology (haematoxylin–eosin 2.5× and 10×): neuroendocrine tumour with a glandular pattern in “nests” and with nuclear hyperchromatism; manifests typical round or oval nuclei with irregular stippled nucleoli. Immunohistochemistry: positive chromogranin.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "K. Pesce, M.J. Chico, J. Sanabria Delgado, A.C. Zabala Sierra, C. Hadad, A. Wernicke" "autores" => array:6 [ 0 => array:2 [ "nombre" => "K." "apellidos" => "Pesce" ] 1 => array:2 [ "nombre" => "M.J." "apellidos" => "Chico" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Sanabria Delgado" ] 3 => array:2 [ "nombre" => "A.C." "apellidos" => "Zabala Sierra" ] 4 => array:2 [ "nombre" => "C." "apellidos" => "Hadad" ] 5 => array:2 [ "nombre" => "A." "apellidos" => "Wernicke" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0033833819300347" "doi" => "10.1016/j.rx.2019.02.004" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0033833819300347?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173510719300540?idApp=UINPBA00004N" "url" => "/21735107/0000006100000004/v2_201907190802/S2173510719300540/v2_201907190802/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173510719300400" "issn" => "21735107" "doi" => "10.1016/j.rxeng.2019.04.001" "estado" => "S300" "fechaPublicacion" => "2019-07-01" "aid" => "1119" "copyright" => "SERAM" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Radiologia. 2019;61:306-14" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 6 "formatos" => array:2 [ "HTML" => 4 "PDF" => 2 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "The administration of contrast media: Is there a risk of acute kidney injury?" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "306" "paginaFinal" => "314" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Administración de medios de contraste. ¿Existe riesgo de daño renal agudo?" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1152 "Ancho" => 1583 "Tamanyo" => 95133 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Percentage of CT scans performed with contrast media. The frequency of administering intravenous contrast in CT examinations decreases as the serum creatinine level increases.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M.D. Ferrer Puchol, P. Montesinos García, M. Forment Navarro, E. Sanz Rodrigo, E. Blanco Pérez, E. Taberner López" "autores" => array:6 [ 0 => array:2 [ "nombre" => "M.D." "apellidos" => "Ferrer Puchol" ] 1 => array:2 [ "nombre" => "P." "apellidos" => "Montesinos García" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Forment Navarro" ] 3 => array:2 [ "nombre" => "E." "apellidos" => "Sanz Rodrigo" ] 4 => array:2 [ "nombre" => "E." "apellidos" => "Blanco Pérez" ] 5 => array:2 [ "nombre" => "E." "apellidos" => "Taberner López" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0033833819300116" "doi" => "10.1016/j.rx.2019.01.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0033833819300116?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173510719300400?idApp=UINPBA00004N" "url" => "/21735107/0000006100000004/v2_201907190802/S2173510719300400/v2_201907190802/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Diagnostic yield of magnetic resonance imaging and intraoperative frozen section in the determination of deep myometrial invasion in endometrial cancer" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "315" "paginaFinal" => "323" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M.F. Sánchez, P.I. Causa Andrieu, C. Latapie, M.C. Saez Perrotta, N. Napoli, M. Perrotta, C.R.B. Chacón, A. Wernicke" "autores" => array:8 [ 0 => array:3 [ "nombre" => "M.F." "apellidos" => "Sánchez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:4 [ "nombre" => "P.I." "apellidos" => "Causa Andrieu" "email" => array:2 [ 0 => "Pamela.causa@hospitalitaliano.org.ar" 1 => "pamcausaandrieu@icloud.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 2 => array:3 [ "nombre" => "C." "apellidos" => "Latapie" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "M.C." "apellidos" => "Saez Perrotta" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "N." "apellidos" => "Napoli" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 5 => array:3 [ "nombre" => "M." "apellidos" => "Perrotta" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 6 => array:3 [ "nombre" => "C.R.B." "apellidos" => "Chacón" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 7 => array:3 [ "nombre" => "A." "apellidos" => "Wernicke" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Ginecología Oncológica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Diagnóstico por Imágenes, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Rédito diagnóstico de la resonancia magnética y el estudio por congelación intraoperatorio en la determinación de la invasión miometrial profunda en cáncer de endometrio" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1389 "Ancho" => 2486 "Tamanyo" => 286130 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">(A) Sagittal T2-weighted magnetic resonance imaging (MRI). (B) Axial T2-weighted MRI. (C) Axial DWI/ADC MRI. (D) Axial T1-weighted gadolinium MRI. (E) IFS: macroscopic specimen. (F) Anatomical pathology. H/E 400×. 52-Year-old female patient, G2P2, studied for initial staging of an endometrial adenocarcinoma, moderate-grade (G2) endometrioid subtype. Initial MRI (A and B). Tumour formation observed with intermediate signal in T2-weighted images (thick arrow), restriction in DWI/ADC (C) and intense enhancement after administration of gadolinium (D) which occupied the anterior uterine wall. Appears to infiltrate the deep myometrium. This was classified as M2. Adjacent small intramural myoma observed (thin arrow). Intraoperative frozen section (IFS) (C): during the surgical procedure the tumour (thick arrow) was distinguished from the posterior leiomyoma (thin arrow). This was classified as M2. Anatomical pathology (D): shows a moderately differentiated G2 endometrioid adenocarcinoma, with deep myometrial invasion (M2) and proximity to the uterine serosa (thick arrow). Findings of the IFS and MRI confirmed.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Endometrial cancer (EC) is the fourth most common cancer found in women in Argentina, after breast cancer, colorectal cancer and tracheal, bronchial and lung cancer.<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">1</span></a> In the USA, there are 60,000 new cases per year, with a mortality rate of 1.7–2.4/100,000 inhabitants.<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">2</span></a> Most cases are sporadic and less than 5% are associated with Lynch syndrome, where there is an abnormality in the mismatch repair genes <span class="elsevierStyleItalic">MLH1</span>, <span class="elsevierStyleItalic">MSH2</span>, <span class="elsevierStyleItalic">MSH6</span> and <span class="elsevierStyleItalic">PMS2</span>.<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Traditionally, EC is categorised into two groups, based on symptoms, epidemiology and the endocrine and metabolic profile. Type 1 tumours are oestrogen-dependent endometrioid adenocarcinomas associated with precursor lesions, such as endometrial intraepithelial neoplasia, which usually have a good prognosis. These are associated with abnormalities in the <span class="elsevierStyleItalic">PTEN</span>, <span class="elsevierStyleItalic">KRAS</span>, <span class="elsevierStyleItalic">CTNNB1</span> and/or <span class="elsevierStyleItalic">PIK3CA</span> genes, among others. Type 2 tumours include histological grade 3 endometrioid and non-endometrioid adenocarcinomas, such as serous carcinomas, carcinosarcomas and clear-cell carcinomas, which are more aggressive, have a worse prognosis and are mostly associated with abnormalities in the <span class="elsevierStyleItalic">p53</span> gene.<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Histologically, EC can present various forms of myometrial invasion (MI), whether as a broad, expansive front or in a diffuse pattern as a mass, cords, groups of cells and in individual glands. This process is accompanied by a desmoplastic stromal response in fibrous tissue and chronic inflammation.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">5</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The International Federation of Gynaecology and Obstetrics (FIGO) uses depth of MI and adjacent organ and tissue involvement as criteria for staging EC. Stage 1 is subdivided into 1A when the tumour invades less than 50% of the myometrium (M1) and 1B when there is more than 50% invasion (M2),<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">6</span></a> which implies a greater risk of lymphovascular space invasion with the resulting risk of lymph node dissemination and probable relapse. The overall five-year survival rate of stage 1A is 88–91%, which falls to 81% in stage 1B.<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">7–9</span></a> Various studies have shown that FIGO stage 1A presents a 5% risk of lymphatic dissemination, but no benefit on survival with routine lymphadenectomies,<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">10–12</span></a> with this procedure actually increasing morbidity in this group of patients.<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The standard treatment for EC is hysterectomy with bilateral salpingo-oophorectomy. It has been established that high-risk patients benefit from para-aortic lymphadenectomy.<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">14,15</span></a> This group includes histological subtypes corresponding to grade 3 endometrioid carcinomas, clear-cell carcinomas, serous carcinoma, carcinosarcoma and dedifferentiated and undifferentiated carcinomas, as well as cases presenting cervical invasion or M2. This information is provided by the clinical examination and analysis of the initial biopsy.<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">16,17</span></a> The presence of M2 is assessed during the surgical procedure using intraoperative frozen section (IFS) and can also be assessed by magnetic resonance imaging (MRI), which is the method recommended by the American College of Radiology and the European Society of Radiology for assessing and staging EC. Both are tools that predict MI with varying degrees of accuracy, helping to reduce unnecessary lymphadenectomies, with the resulting implications for the patient and health care system.<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">18,19</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Our main objective was to calculate the diagnostic yield of IFS and MRI for determining the presence of M2 in EC. As a secondary objective, we intended to calculate the diagnostic accuracy rate of both methods for determining M2 and to distinguish the percentage of under- and overestimation. Finally, as a tertiary objective, we intended to estimate the predictive capacity of MRI for determining the presence of M2, adjusting it for the known histological variables linked to poor prognosis.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><p id="par0035" class="elsevierStylePara elsevierViewall">In accordance with Argentinian Law 25,326 on Personal Data Protection (Habeas Data Law) and following the authorisation of the Independent Ethics Committee of the Hospital Italiano de Buenos Aires, Argentina, a cross-sectional diagnostic test study was performed.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Using a database of 227 patients with a pathological diagnosis of EC following a hysterectomy, 160 patients were studied who met the following inclusion criteria: initial pathological diagnosis after the hysteroscopy biopsy, pre-operative MRI and hysterectomy (with or without oophorectomy) at our institution. The study period was from 1 January 2010 to 31 December 2017. The inclusion criteria are shown in <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">The gadolinium-enhanced gynaecological pelvis MRI was performed with 1.5 T equipment (Magnetom Avanto and Essenza, Siemens, Erlangen, Germany) using surface coils. The patients were asked to fast for three hours and were given intravenous hyoscine butylbromide before the scan to reduce peristalsis.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Morphological T2-weighted sequences were obtained in the axial, sagittal and coronal planes, fat-suppressed T1-weighted sequences in the axial plane and T1-weighted sequences in the sagittal plane. Diffusion-weighted imaging (DWI. <span class="elsevierStyleItalic">b</span>-value: 0–50–1000<span class="elsevierStyleHsp" style=""></span>s/mm<span class="elsevierStyleSup">2</span>) was then performed with its corresponding apparent diffusion coefficient (ADC). Gadolinium (Gadobutrol, Gadovist: Bayer, Berlin, Germany) was manually injected at a dose of 0.1<span class="elsevierStyleHsp" style=""></span>ml per kg of body weight, followed by 10<span class="elsevierStyleHsp" style=""></span>ml of physiological saline solution. The images were taken sequentially, 20<span class="elsevierStyleHsp" style=""></span>s before the injection of the bolus, over a total period of 180<span class="elsevierStyleHsp" style=""></span>s. Five fat-suppressed volumetric T1-weighted sequences were obtained, with and without intravenous contrast, as well as their corresponding subtraction sequences (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">The IFS was performed by means of macroscopic analysis of the surgical specimen. The focus with the greatest myometrial infiltration was identified, guided by the MRI findings, and the frozen section procedure was performed in a cryostat. The slices were then stained with haematoxylin and eosin techniques.</p><p id="par0060" class="elsevierStylePara elsevierViewall">All the MRIs were analysed by radiologists experienced in gynaecological MRI, with 12 and 5 years of experience, using unified reporting criteria. At the time of analysis, the reporting physicians knew the age and US findings at the time of diagnosis but did not know the result of the initial biopsy.</p><p id="par0065" class="elsevierStylePara elsevierViewall">The MRI findings and IFS sheets were compared with the final MI depth data from the anatomical pathology report. This was performed by members of the research team who only knew the patient's age and not the result of the initial biopsy.</p><p id="par0070" class="elsevierStylePara elsevierViewall">A statistical analysis on sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) was performed for both diagnostic tests. The predictive value of MRI for determining the presence of M2 was also calculated and adjusted for the known histological variables linked to poor prognosis.</p><p id="par0075" class="elsevierStylePara elsevierViewall">The results were considered significant when the <span class="elsevierStyleItalic">p</span>-value was less than 0.05. The data were analysed with the STATA/IC software (data analysis and statistical software for professionals), together with our institution's statistics team.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0080" class="elsevierStylePara elsevierViewall">The patients’ characteristics and qualitative MRI and anatomical pathology findings were summarised using descriptive statistics and expressing summary measures of central tendency and distribution. The continuous variables were described in terms of the mean and standard deviation (SD) or median and interquartile range, according to distribution, and the categorical variables were expressed as absolute and relative frequencies.</p><p id="par0085" class="elsevierStylePara elsevierViewall">A total of 160 patients diagnosed with EC were analysed, who were assessed with a pre-operative MRI. These data are presented in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>. The average age of the patients was 65.78 years (SD: 10.8 years). The frequency of M1 and M2 observed by MRI is also shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>.</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">IFS was performed in 119 patients (74.3%); in the remaining 41 cases IFS was not performed as the patients had high-risk histological subtypes and/or histological grade 3. The frequency of M1 and M2 observed by IFS is shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>.</p><p id="par0095" class="elsevierStylePara elsevierViewall">The statistical analysis on the sensitivity, specificity, PPV and NPV of both methods for determining M2 (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>) produced a statistically significant result (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05), as described below. MRI had a sensitivity of 63%, a specificity of 87%, a PPV of 73% and a NPV of 81%; IFS had a sensitivity of 69%, a specificity of 86.7%, a PPV of 69% and a NPV of 86%. The degree of agreement between both methods was estimated using Cohen's kappa coefficient, with a result of 0.53 (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.00001), according to which it can be concluded that the agreement between both methods is moderate and statistically significant.</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">The diagnostic accuracy rate of MRI was 78.75% (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>126/160); 13.12% (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>21/160) of the cases underestimated and 8.13% (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>13/160) overestimated M2. Meanwhile, the diagnostic accuracy of IFS was 81.51% (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>97/119). 9.24% (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>11/119) of the cases underestimated and 9.24% (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>11/119) overestimated M2.</p><p id="par0105" class="elsevierStylePara elsevierViewall">Finally, a strong association between the MRI result and the final anatomical pathology analysis for determining the presence of M2 was found (odds ratio: 11.91, 95% confidence interval [CI]: 5.27–26.94), also adjusted for high-risk and/or histological grade 3 subtypes.</p><p id="par0110" class="elsevierStylePara elsevierViewall">Having analysed both diagnostic methods, they were found to have a similar and adequate diagnostic capacity, although IFS was favourable for determining the presence of M2.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0115" class="elsevierStylePara elsevierViewall">In our experience, and similar to what has been published in the specialist literature, MRI has an adequate sensitivity (63%), specificity (87%), PPV (73%) and NPV (81%) for determining the presence of M2.<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">16,18–22</span></a> Although our study population included patients who had other poor prognosis factors, irrespective of the degree of MI, it should be highlighted that over 70% had the low-grade endometrioid histological type. On performing a statistical risk analysis, it was found that the predictive tendency of MRI is maintained even when adjusting for high-risk and/or histological grade 3 subtypes. We therefore feel that our results resemble those documented in the specialist literature, and fundamentally, those of clinical relevance (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall">Most of the discrepancies noted were due to technical or anatomical difficulties, which led to the incorrect interpretation of MI depth. Underestimation was related to the presence of adenomyosis, uterine myomas, retroverted uteruses with myometrial thinning or distension, and/or technical artefacts; overestimation of MI with imaging, on the other hand, could be explained by the presence of desmoplasia and/or stromal oedema, which hinders tumour interpretation by MRI (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>).</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0125" class="elsevierStylePara elsevierViewall">There are technical tools in MRI which help to reduce the error rate. One of these is the acquisition of T2-weighted axial slices perpendicular to the long axis of the endometrial cavity, which allow the axial extension of the tumour to be accurately assessed.</p><p id="par0130" class="elsevierStylePara elsevierViewall">Moreover, advanced diffusion sequences (DWI-ADC) and dynamic assessment subsequent to the administration of contrast provide increased differentiation between the myometrium-tumour interface and improved MI determination. This is useful when the tumour is isointense to the myometrium in T2-weighted sequences, when the uterus is retroverted, the tumour extends towards the cornual regions or in the presence of adenomyosis and/or associated myomas. For the reasons mentioned above, T2, DWI-ADC and VIBE (volumetric interpolated breath-hold examination) sequences are considered the “one-stop shop” for proper pre-operative staging.<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">4,18</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">Transvaginal sonography (TVS) is also highly useful both in the diagnosis and staging of EC. With this technique, not only should the endometrial cavity be assessed in greyscale—as in Doppler ultrasonography—but the interface between the endometrium-inner myometrium and deep myometrium should also be studied. There are cases with myometrial involvement and scant endocavity expression, where the endometrial lining could be seen as “thin” if the appearance of the underlying myometrium is not analysed. In the most recent systematic review carried out by Alcázar et al., it was concluded that although the sensitivity and specificity of TVS are slightly lower than in MRI (75% and 82% versus 83% and 83%, respectively), this difference is not statistically significant.<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">23</span></a> However, as mentioned, other articles such as the one by Nougaret et al. discuss the additional benefits of MRI sequences to reduce the rate of interpretation errors in light of factors such as adenomyosis, myomatosis and reverted uteruses etc., the presence of which hinders the interpretation of the transvaginal ultrasound.<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">4</span></a> In view of the above, in our department we use TVS to assess patients with postmenopausal metrorrhagia or abnormal uterine bleeding, and MRI for locoregional and distant staging.</p><p id="par0140" class="elsevierStylePara elsevierViewall">Similarly, both in our own experience and in the specialist literature, IFS presents adequate sensitivity, specificity, PPV and NPV for determining the presence of M2.<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">24–26</span></a> Discrepancies were mostly due to the degree of MI being overestimated, as a result of the tumour extending into foci of adenomyosis and the presence of leiomyomas deforming the uterine cavity. These could have been prevented with successive frozen sections of the rest of the uterine cavity. Although the number of patients is lower due to the fact that not all patients underwent IFS procedures, the results were within the 95% CI (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>).</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0145" class="elsevierStylePara elsevierViewall">Although our results, like those reported in the literature, show MRI to have a lower diagnostic yield than IFS,<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a> the contribution of MRI in revealing the site likely to exhibit the greatest invasion and possible confounding factors, guides the pathologist during the IFS. Both methods therefore play a part in optimising decision-making during the surgical procedure.</p><p id="par0150" class="elsevierStylePara elsevierViewall">Some groups have implemented the use of sentinel lymph node biopsy with delayed histopathological study. This is performed in patients where disease is thought to be confined to the endometrium without evident metastasis, in order to determine the need for lymphadenectomy.<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">27–29</span></a> In recent years, numerous studies have also analysed the genomic profile of endometrial tumours and a molecular classification has been proposed which enables prognostic information to be obtained irrespective of pre-established morphological factors. In the future, when used routinely, this tool will allow additional criteria to be applied to guide the treatment of people with EC.<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">18,30</span></a> We leave both perspectives under consideration for future studies by our team.</p><p id="par0155" class="elsevierStylePara elsevierViewall">In our experience, MRI and IFS present an adequate diagnostic yield, although IFS was favourable for determining M2. The contribution of MRI in determining the presence and site of deep MI as well as potentially confounding factors, combined with the contribution of IFS, means that both methods help to reduce the number of unnecessary lymphadenectomies, with the associated morbidity and mortality and health care costs.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Authorship</span><p id="par0160" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1.</span><p id="par0165" class="elsevierStylePara elsevierViewall">Responsible for the integrity of the study: SFM and CAPI.</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2.</span><p id="par0170" class="elsevierStylePara elsevierViewall">Article conception: SFM and CAPI.</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">3.</span><p id="par0175" class="elsevierStylePara elsevierViewall">Article design: SFM and CAPI.</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">4.</span><p id="par0180" class="elsevierStylePara elsevierViewall">Data collection: LC, SFM and CAPI.</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">5.</span><p id="par0185" class="elsevierStylePara elsevierViewall">Data analysis and interpretation: SFM and CAPI.</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">6.</span><p id="par0190" class="elsevierStylePara elsevierViewall">Statistical processing: SFM and CAPI.</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">7.</span><p id="par0195" class="elsevierStylePara elsevierViewall">Literature search: SFM and CAPI.</p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">8.</span><p id="par0200" class="elsevierStylePara elsevierViewall">Drafting of the paper: SFM and CAPI.</p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">9.</span><p id="par0205" class="elsevierStylePara elsevierViewall">Critical review of the manuscript with intellectually significant contributions: SPMC and MNN.</p></li><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">10.</span><p id="par0210" class="elsevierStylePara elsevierViewall">Approval of the final version: CCRB, PM and WA.</p></li></ul></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflicts of interest</span><p id="par0215" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres1220917" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background and objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Materials and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1135469" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1220916" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Antecedentes y objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Materiales y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1135470" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Materials and methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Authorship" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflicts of interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2018-07-09" "fechaAceptado" => "2019-01-29" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1135469" "palabras" => array:4 [ 0 => "Endometrial neoplasms" 1 => "Magnetic resonance imaging" 2 => "Intraoperative assessment" 3 => "Lymph node dissection" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1135470" "palabras" => array:4 [ 0 => "Neoplasias endometriales" 1 => "Resonancia magnética" 2 => "Evaluación intraoperatoria" 3 => "Linfadenectomía" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background and objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The standard treatment for endometrial cancer is simple hysterectomy with bilateral salpingo-oophorectomy. Patients with high risk also benefit from lumbo-aortic lymphadenectomy. High risk patients include those with grades and histologic subtypes associated with poor prognosis and depth of myometrial invasion greater than 50% (M2). To determine which patients would benefit from lumbo-aortic lymphadenectomy, the depth of myometrial invasion can be assessed by intraoperative frozen section or by magnetic resonance imaging (MRI). We aimed to determine the diagnostic yield of intraoperative frozen section and MRI for detecting the presence of M2 in patients with endometrial cancer.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Materials and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">This cross-sectional study included women with a histologically confirmed diagnosis of endometrial cancer who underwent baseline MRI and surgical intervention in our institution between 1 January 2010 and 31 December 2017. We reviewed the MRI studies and the intraoperative frozen section reports and compared them with the information in the histopathology report. We compared the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the two tests. We also calculated the diagnostic accuracy of each method and the percentages of underestimation and overestimation. Finally, we calculated the predictive value of MRI for the presence of M2, adjusting it for the histologic variables known to be associated with poor prognosis.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">To detect M2, MRI had 63% sensitivity, 87% specificity, 73% PPV, and 81% NPV; the diagnostic accuracy was 78.8%, with 13.12% underestimation and 8.13% overestimation of M2. Intraoperative frozen section had 69% sensitivity, 86.7% specificity, 69% PPV, and 86% NPV; the diagnostic accuracy was 81.5%, with 9.24% underestimation and 9.24% overestimation of M2. The degree of concordance between the two methods was moderate (<span class="elsevierStyleItalic">k</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.54, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.00001).</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">In our experience, MRI and intraoperative frozen section have adequate diagnostic yields for determining M2, though intraoperative frozen section is slightly better. The contribution of MRI in determining the presence and the site of deep myometrial invasion, as well as the factors that can confound the diagnosis, when added to the contribution of intraoperative frozen section, means that both methods help reduce the number of unnecessary lymph node dissections and the morbidity, mortality, and health costs associated with this practice.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background and objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Materials and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Antecedentes y objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El tratamiento estándar para el cáncer de endometrio (CE) es la histerectomía simple con salpingo-ooforectomía bilateral. Las pacientes dentro del grupo de alto riesgo son las que se benefician de la linfadenectomía lumboaórtica. En dicho grupo se encuentran las que presentan grado y subtipo histológico de mal pronóstico y profundidad de invasión miometrial superior al 50% (M2). Este último parámetro puede ser brindado por el estudio intraoperatorio por congelación (EIC) y la resonancia magnética (RM), contribuyendo a decidir quiénes se beneficiarán de la linfadenectomía. El objetivo es establecer el rédito diagnóstico de la RM y EIC para determinar la presencia de M2 en pacientes con CE.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Materiales y métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio de tipo test diagnóstico, corte transversal. Se incluyeron pacientes de sexo femenino con diagnóstico histopatológico de CE, a las que se realizó RM inicial o basal y fueron intervenidas quirúrgicamente en nuestra institución entre el 1 de enero de 2010 y el 31 de diciembre de 2017. Se estudiaron las RM y los informes de EIC y se compararon con los datos del informe de anatomía patológica. Se efectuó un análisis estadístico de sensibilidad, especificidad, valor predictivo positivo (VPP) y valor predictivo negativo (VPN) de ambas pruebas diagnósticas. También se calculó la tasa de precisión diagnóstica de cada método discriminado, el porcentaje de subestimación y sobrestimación. Finalmente, se calculó el valor predictivo de la RM para determinar la presencia de M2 ajustándolo por las variables histológicas de mal pronóstico conocidas.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Para la determinación de M2, la RM presentó una sensibilidad del 63%, una especificidad del 87%, un VPP del 73% y un VPN del 81%. La tasa de precisión diagnóstica fue del 78,8%, un 13,12% por subestimación y un 8,13% por sobrestimación de M2. Por su parte, el EIC presentó una sensibilidad del 69%, una especificidad del 86,7%, un VPP del 69% y un VPN del 86%. La tasa de precisión diagnóstica fue del 81,5%, un 9,24% por subestimación y 9,24% por sobrestimación de M2. El grado de concordancia entre ambos métodos es moderada (valor de kappa de 0,54, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,00001).</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">En nuestra experiencia, la RM y el EIC presentan un adecuado rédito diagnóstico, pero a favor del EIC, para determinar M2. La contribución de la RM al determinar la presencia y el sitio de invasión miometrial profunda, así como de los factores que puedan resultar confundidores, sumado al aporte de la EIC, se traduce en que ambos métodos ayudan a disminuir el número innecesario de linfadenectomías, con la morbimortalidad y los costos en salud asociados.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Antecedentes y objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Materiales y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Sánchez MF, Causa Andrieu PI, Latapie C, Saez Perrotta MC, Napoli N, Perrotta M, et al. Rédito diagnóstico de la resonancia magnética y el estudio por congelación intraoperatorio en la determinación de la invasión miometrial profunda en cáncer de endometrio. Radiología. 2019;61:315–323.</p>" ] ] "multimedia" => array:7 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2471 "Ancho" => 2083 "Tamanyo" => 176207 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Patient screening process.</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">EC: endometrial cancer; HT-HTBSO: hysterectomy–hysterectomy and bilateral salpingo-oophorectomy; MRI: magnetic resonance imaging; IFS: intraoperative frozen section.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1455 "Ancho" => 2167 "Tamanyo" => 287849 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">(A) Sagittal T2-weighted magnetic resonance imaging (MRI). (B) Axial T2-weighted MRI. (C) Intraoperative frozen section (IFS): macroscopic specimen. (D) Anatomical pathology. H/E 400×. 54-Year-old female patient, G2P2, studied for initial staging of an endometrial adenocarcinoma, low-grade (G1) endometrioid subtype. Initial MRI (A and B). Tumour formation observed with intermediate signal in T2-weighted images (thick arrow), restriction in DWI/ADC and intense enhancement after administration of gadolinium (images of the latter two characteristics not shown). Inner myometrium seen to present diffuse adenomyosis (thin arrow) with invasion by the tumour, but no deep myometrial involvement. This was classified as M1. IFS (C): during the surgical procedure the tumour (thick arrow) was distinguished from the diffuse adenomyosis with haemorrhagic areas (thin arrow). This was classified as M1. Anatomical pathology (D): revealed a well differentiated G1 endometrioid adenocarcinoma with superficial myometrial invasion (thick arrow) and extension into foci of adenomyosis (thin arrow). Findings of the IFS confirmed.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1389 "Ancho" => 2486 "Tamanyo" => 286130 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">(A) Sagittal T2-weighted magnetic resonance imaging (MRI). (B) Axial T2-weighted MRI. (C) Axial DWI/ADC MRI. (D) Axial T1-weighted gadolinium MRI. (E) IFS: macroscopic specimen. (F) Anatomical pathology. H/E 400×. 52-Year-old female patient, G2P2, studied for initial staging of an endometrial adenocarcinoma, moderate-grade (G2) endometrioid subtype. Initial MRI (A and B). Tumour formation observed with intermediate signal in T2-weighted images (thick arrow), restriction in DWI/ADC (C) and intense enhancement after administration of gadolinium (D) which occupied the anterior uterine wall. Appears to infiltrate the deep myometrium. This was classified as M2. Adjacent small intramural myoma observed (thin arrow). Intraoperative frozen section (IFS) (C): during the surgical procedure the tumour (thick arrow) was distinguished from the posterior leiomyoma (thin arrow). This was classified as M2. Anatomical pathology (D): shows a moderately differentiated G2 endometrioid adenocarcinoma, with deep myometrial invasion (M2) and proximity to the uterine serosa (thick arrow). Findings of the IFS and MRI confirmed.</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1457 "Ancho" => 2029 "Tamanyo" => 270884 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">(A) Sagittal T2-weighted magnetic resonance imaging (MRI). (B) Axial T2-weighted MRI. (C) Intraoperative frozen section (IFS): macroscopic specimen. (D) Anatomical pathology. H/E 400×. 68-Year-old female patient, G3P3, studied for initial staging of an endometrial adenocarcinoma, low-grade (G1) endometrioid subtype. Initial MRI (A and B). Tumour formation observed with intermediate signal in T2-weighted images (thick arrow), restriction in DWI/ADC and intense enhancement after administration of gadolinium (images of the latter two characteristics not shown) which occupied the anterior uterine wall. Appears to involve the deep myometrium. Concluded to be M2. Posterior small intramural myoma observed (thin arrow). IFS (C): during the surgical procedure the tumour (thick arrow) was distinguished from the posterior leiomyoma (thin arrow). Concluded to be M1. Anatomical pathology (D): reveals the presence of a well differentiated G1, predominately intramucosal endometrioid adenocarcinoma, with small foci of initial myometrial invasion (thick arrow). Findings of the IFS and MRI confirmed. In this case, the MRI provided a false positive. In a retrospective analysis it was observed that the artefact had caused the confusion due to movement.</p>" ] ] 4 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">DWI/ADC: diffusion weighted images/apparent diffusion coefficient; FOV: field of view; GAP: spaces between slices/distance factor; T1 FS: T1 with fat saturation; VIBE: volumetric interpolated breath-hold examination.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="\n \t\t\t\t\ttable-head\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Sequence \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="5" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Parameters</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Planes \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Angle \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Slice thickness \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">GAP \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">FOV \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">T2</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sagittal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15° \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4<span class="elsevierStyleHsp" style=""></span>mm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">220 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Coronal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0° \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4<span class="elsevierStyleHsp" style=""></span>mm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">220 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Axial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0° \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4<span class="elsevierStyleHsp" style=""></span>mm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">220 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">“Thin-slice” axial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Perpendicular to the endometrial cavity \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3<span class="elsevierStyleHsp" style=""></span>mm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0–10% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">220 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">T1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sagittal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15° \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4<span class="elsevierStyleHsp" style=""></span>mm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">220 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">T1 FS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Axial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0° \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4<span class="elsevierStyleHsp" style=""></span>mm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">220 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">DWI/ADC \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Axial. <span class="elsevierStyleItalic">B</span> values: <span class="elsevierStyleItalic">B</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0, <span class="elsevierStyleItalic">B</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>50, <span class="elsevierStyleItalic">B</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0° \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4<span class="elsevierStyleHsp" style=""></span>mm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">220 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="6" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.1<span class="elsevierStyleHsp" style=""></span>ml of gadolinium (Gadobutrol, Gadovist: Bayer, Berlin, Germany) per kg of body weight, administered manually, followed by 10<span class="elsevierStyleHsp" style=""></span>ml of physiological saline solution</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Dynamic VIBE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Axial. 5 sequential sequences. 1 without contrast and 4 with contrast starting 20<span class="elsevierStyleHsp" style=""></span>s before injection of the bolus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Perpendicular to the endometrial cavity \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4<span class="elsevierStyleHsp" style=""></span>mm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">220 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">T1 FS post-gadolinium</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Axial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0° \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4<span class="elsevierStyleHsp" style=""></span>mm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">220 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sagittal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15° \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4<span class="elsevierStyleHsp" style=""></span>mm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">220 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2084962.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Gynaecological pelvis magnetic resonance imaging protocol.</p>" ] ] 5 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">AP: anatomical pathology; IFS: intraoperative frozen section; M1: superficial invasion; M2: deep invasion; MRI: magnetic resonance imaging.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Subtype \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Frequency \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Grade \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Frequency \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Initial FIGO stage</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="9" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Initial histological diagnosis from the hysteroscopy biopsy</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Endometrioid</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">128 (80%)</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">G1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">86 (53.75%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">95 (59.37%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">G2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32 (20%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">43 (26.85%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">G3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (6.25%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Serous \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 (9.37%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (6.25%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Carcinosarcoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (4.37%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (0.65%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mixed \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (2.5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3C1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (2.55%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Undifferentiated \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (1.25%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3C2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (3.73%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Clear cells \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (1.25%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (0.62%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Dedifferentiated \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (0.62%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4B \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="7" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Frequency of superficial (M1) and deep (M2) myometrial invasion</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">MRI</span><span class="elsevierStyleItalic">(n</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">=</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">160)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">IFS</span><span class="elsevierStyleItalic">(n</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">=</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">119)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">AP</span><span class="elsevierStyleItalic">(n</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">=</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">160)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">M1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">111 (69.38%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">83 (69.74%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">103 (64.3%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">M2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">49 (30.63%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36 (30.25%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">57 (35.6%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2084964.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Demographic characteristics, initial diagnosis from the hysteroscopy biopsy, frequency of superficial and deep myometrial invasion, and initial stage according to FIGO.</p>" ] ] 6 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">AP: anatomical pathology; IFS: intraoperative frozen section; M1: superficial invasion; M2: deep invasion; MRI: magnetic resonance imaging.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Myometrial invasion by AP</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Total \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">M1 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">M2 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">MRI</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>M1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">90 (87.38%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 (36.84%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">111 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>M2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (12.62%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36 (63.15%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">49 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">103 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">57 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">IFS</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>M1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">72 (86.75%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (30.55%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">83 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>M2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (13.35%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 (69.45%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">83 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2084963.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Results of magnetic resonance imaging and intraoperative frozen section for determining myometrial invasion distinguishing between the superficial (M1) and deep (M2) variants.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:30 [ 0 => array:3 [ "identificador" => "bib0155" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "De. 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Original article
Diagnostic yield of magnetic resonance imaging and intraoperative frozen section in the determination of deep myometrial invasion in endometrial cancer
Rédito diagnóstico de la resonancia magnética y el estudio por congelación intraoperatorio en la determinación de la invasión miometrial profunda en cáncer de endometrio