Title: 2D & 3D Doppler Study of Ovarian Tumors in A Tertiary Care Hospital in Chennai, Southern India
Authors: Dr A.Mangala Geetha MD DGO DNB, Dr S. Kalaivani MS (OG) DNB, Dr Vinodhini Shanmugham
DOI: https://dx.doi.org/10.18535/jmscr/v5i7.130
Abstract
Ovarian tumors constitute second most common type of tumors involving the reproductive tract of women following cancer cervix in India. To discriminate the
nature of ovarian lesions is of particular importance in gynecological practice. Two main problems need answers - discrimination of benign and malignant adnexal masses and choice of the appropriate surgical treatment if necessary. The aim of this study was to perform 2D and 3D power Doppler ultrasound of ovarian tumors and to compare the results with the histopathology report following surgery and thence to determine the accuracy of Doppler findings in differentiating malignant and benign ovarian tumors.
This study was done at Govt. Kilpauk Medical College, a tertiary care teaching hospital in Chennai, Southern India, on all women who were posted for surgery in view of ovarian mass of size more than 5cm detected clinically. 2D and 3D grey scale ultrasound and color Doppler content of the tumor scan was done and rated subjectively by the ultrasound examiner on a visual analog scale. Vascularization index (VI), flow index (FI) and vascularization flow index (VFI) were calculated in the whole tumor and in a 5-cm3 sample taken from the most vascularized area of the tumor. Logistic regression analysis was used to build models to predict malignancy. The Doppler study results were then compared with the histopathology reports following surgery. It was established that the 3D Power Doppler findings suggestive of malignancy correlated well with the histopathology of the tumors thus substantiating the fact that Doppler ultrasonography is very useful in differentiating between benign and malignant tumor in the pre-operative assessment planning period.
References
1. Timor-Trish IE, Lerner JP, Montegudo A, Santos R, Transvaginal Ultrasonographic charecterisation of ovarian masses by means of color-flow Doppler measure-ments and a morphologic scoring system.
2. 2.Lerner JP, Timor Trish LE, Federman A, Abramovich G. Transvaginal ultrasonographic charecterisation of ovarian masses with an improved, weighted scoring system.
3. Buy JN, Ghossain MA, Hugol D, et al. Characterization of adnexal masses: combination of color Doppler and conventional sonography compared with spectral Doppler analysis alone and conventional sonography alone..
4. 4.Wu CC, Lee CN, Chen TM, Lai JI, Hsieh CY, Hwieh FJ. Factors contributing to the accuracy in diagnosing ovarian malignancy by color Doppler ultrasound. Obstet Gynecol 1994
5. Predanic M, Vlahos N, Pennisi JA, Moukhtar M, Alee FA. Color and pulsed Doppler sonography, gray-scale imaging, and serum CA 125 in the assessment of adnexal disease.
6. 6.Jacobs I, Oram D, Fairbanks J, Turner J, Frost C, Grudzinskas JG. A risk of malignancy index incorporating CA 125, ultrasound and menopausal status for the accurate preoperative diagnosis of ovarian cancer.
7. Timmerman D, Schwarzler P, Collins WP, et al. Subjective assessment of adnexal masses with the use of ultrasonography: an analysis of interobserver variability and experience.
8. Fleischer AC, Cullinan JA, Peery CV, Jones HW III. Early detection of ovarian carcinoma with transvaginal color Doppler ultrasonography.
9. Fleischer AC, Rodgers WH, Kepple DM, Williams LL, Jones HW III. Color Doppler sonography of ovarian masses: a multiparameter analysis. J Ultrasound Med 1993
10. 10.Kurjak A, Zalud I, Alfirevic Z. Evaluation of adnexal masses with transvaginal color ultrasound.
11. Kurjak A, Predanic M. New scoring system for prediction of ovarian malignancy based on transvaginal color Doppler sonography.
12. Sassone AM, Timor-Trish IE, Artner A, Westhoff C, Warren WB. Transvaginal sonographic characterization of ovarian disease: evaluation of a new scoring system to predict ovarian malignancy.
13. DePriest PD, Varner E, Powell J, et al. The efficacy of a sonographic morphology index in identifying ovarian cancer: a multi-institutional investigation.
14. Twickler DM, Forte TB, Santos-Ramos R, McIntire D, Harris P, Miller DS. The ovarian tumor index predicts risk for malignancy.
15. Timmerman D, Valentin L, Bourne TH, Collins WP, Verrelst H, Vergote I. Terms, definitions and measurements to describe the sonographic features of adnexal tumors: a consensus opinion from the International Ovarian Tumor Analysis (IOTA) group.
16. Jacobs IJ, Stabile I, Bridges J, et al. Multimodal approach to screening for ovarian cancer.
Dr Vinodhini Shanmugham
Post Gradate Resident, Dept of Obstetrics and Gynecology,
Govt Kilpauk Medical college Hospital, Kilpauk, Chennai -600010 Tamil Nadu