Three-dimensional quantification of tumor vascularity as a tertiary test after B-mode and power Doppler evaluation for detection of ovarian cancer.
OBJECTIVE
The purpose of this study was to investigate the role of 3-dimensional (3D) quantification of tumor vascularity in the differential diagnosis of pelvic indeterminate masses with a solid appearance or unilocular or multilocular cysts with a solid component showing central vascularization on 2-dimensional power Doppler sonography.


METHODS
One hundred fifty-seven consecutive pelvic masses in 153 patients were included in this study and underwent sonography before surgery. Masses that showed a typical benign pattern on B-mode sonography (n = 112) and indeterminate masses with peripheral or absent flow on power Doppler sonography (n = 10) were not evaluated by 3D sonography. Only masses with central vascularization were submitted to 3D power Doppler imaging (n = 35). The following 3D vascular parameters were calculated: relative color and flow measure (similar to the vascularization flow index obtained with other systems).


RESULTS
With receiver operating characteristic curve analysis, the best cutoff values for relative color and flow measure were 4.4 and 2.7, respectively. Flow measure had sensitivity of 68% and specificity of 40% in the overall population submitted to 3D power Doppler sonography. Accuracy slightly increased when masses with small papillary projections (<10 mL) were excluded. In this group (n = 22), sensitivity was 83%, and specificity was 50%.


CONCLUSIONS
In masses with central vascularization on 2-dimensional power Doppler sonography, the use of 3D quantification of tumor vascularity had low diagnostic accuracy in the detection of adnexal malignancies, although an increase in accuracy in masses with a solid portion of greater than 10 mL was reported.
Guerriero
Stefano
S
Department of Obstetrics and Gynecology, University of Cagliari, Ospedale San Giovanni di Dio, Via Ospedale 46, 09124 Cagliari, Italy. gineca.sguerriero@tiscali.it
Ajossa
Silvia
S
Piras
Silvia
S
Gerada
Marta
M
Floris
Stefano
S
Garau
Nicoletta
N
Minerba
Luigi
L
Paoletti
Anna Maria
AM
Melis
Gian Benedetto
GB
D001783:Blood Flow Velocity; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging; D010051:Ovarian Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D012039:Regional Blood Flow; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D014463:Ultrasonography / Q000379:methods*; D018615:Ultrasonography, Doppler, Color