A critical evaluation of transvaginal Doppler studies, transvaginal sonography, magnetic resonance imaging, and CA 125 in detecting ovarian cancer.
OBJECTIVE
To evaluate whether transvaginal Doppler ultrasound is more valid than transvaginal sonography, magnetic resonance imaging (MRI), and CA 125 in differentiating malignant from benign ovarian tumors.


METHODS
Sixty-three patients with ovarian tumors (36 benign and 27 malignant) were studied with transvaginal Doppler ultrasound before surgery. Blood flow velocity waveforms arising from intratumoral and/or tumor surface arteries were assessed by calculating the resistance index. Transvaginal B-mode sonography and MRI imaging examinations were also conducted. Serum CA 125 levels were measured.


RESULTS
There was a significant difference between the resistance index value (0.692 +/- 0.188) in benign tumors and the value (0.503 +/- 0.107) in malignant tumors (P < .05). When 0.72 (mean of the malignant tumor resistance index values + 2 standard deviations) was considered as the cutoff value of the resistance index, the sensitivity and specificity of the resistance index in detecting malignant ovarian tumors were 92.6 and 52.8%, respectively. These values did not differ significantly from those with transvaginal sonography diagnosis (sensitivity 85.2%, specificity 69.4%). The resistance index sensitivity was significantly higher than those with MRI diagnosis (66.7%) and CA 125 levels (59.3%) (P < .05); however, the resistance index specificity was significantly lower than those with MRI diagnosis (97.1%) and CA 125 levels (91.7%) (P < .05).


CONCLUSIONS
Our results suggest that transvaginal Doppler ultrasound does not provide more useful diagnostic information than transvaginal sonography, MRI, and CA 125 for the differentiation of malignant from benign ovarian tumors.
Hata
K
K
Department of Obstetrics and Gynecology, Shimane Medical University, Izumo, Japan.
Hata
T
T
Manabe
A
A
Sugimura
K
K
Kitao
M
M
D000328:Adult; D000368:Aged; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000097:blood*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*; D014621:Vagina
D015295:Antigens, Tumor-Associated, Carbohydrate