Color Doppler velocimetry and three-dimensional color power angiography of cervical carcinoma.
OBJECTIVE
To investigate the blood flow within invasive cervical carcinoma by transvaginal two-dimensional (2D) color spectral Doppler and three-dimensional (3D) color power angiography and to correlate these parameters with the clinicopathological characteristics.


METHODS
Seventy-four patients with invasive cervical carcinoma were enrolled for the analysis. Squamous cell carcinoma serum antigen levels (SCC) were obtained for all the patients. Sections of all malignant tissues were analyzed for tumor expression of cyclooxygenase-2 (COX-2). All patients underwent color and spectral Doppler examination and 44 patients had 3D color power angiography. Color spectral Doppler parameters (color score, lowest resistance index (RI), highest peak systolic velocity (PSV)) and 3D color power angiography indices (relative color, average color, flow measure) of FIGO I/II cervical cancers were compared with those obtained in a control group of 24 patients with a normal uterine cervix. Pulsed Doppler parameters and the 3D vascular indices were compared with clinicopathological parameters, SCC serum antigen levels and tumor COX-2 expression.


RESULTS
At color Doppler analysis 72 patients (97%) showed intralesional detectable vessels. Color spectral Doppler and 3D-derived parameters were significantly different in FIGO I/II cervical cancers compared with those in women with a normal cervix. A significantly higher color score (P = 0.0008), lower RI (P = 0.032) and higher PSV (P = 0.004) were associated with a tumor diameter > or =4 cm compared with smaller tumors. The highest PSV was significantly higher in patients with FIGO stage III/IV compared with FIGO stage I/II (P = 0.0069). There was a direct correlation between PSV and SCC (r = +0.44, P = 0.003). The median relative color was significantly higher in patients with a higher color score (P = 0.0006). No statistically significant correlations were found between 3D color power angiography parameters and the clinicopathological characteristics or between the 3D vascular parameters and biological factors.


CONCLUSIONS
Alterations of 3D ultrasound-derived vascular indices were found in patients with cervical cancer compared with those with a normal cervix. Moreover, some vascular indices proved to be associated with tumor size. The assessment of a possible clinical role of 2D and 3D ultrasound-derived vascular indices in cervical cancer deserves further investigation.
Testa
A C
AC
Department of Gynecology/Obstetrics, Catholic University of the Sacred Heart, Rome, Italy. atesta@rm.unicatt.it
Ferrandina
G
G
Distefano
M
M
Fruscella
E
E
Mansueto
D
D
Basso
D
D
Salutari
V
V
Scambia
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods; D001783:Blood Flow Velocity / Q000502:physiology; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D017078:Laser-Doppler Flowmetry / Q000379:methods; D008875:Middle Aged; D011446:Prospective Studies; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D002583:Uterine Cervical Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging