Spherical tissue sampling in 3-dimensional power Doppler angiography: a new approach for evaluation of ovarian tumors.
OBJECTIVE
The purpose of this study was to evaluate the usefulness of virtual spherical tissue sampling using 3-dimensional (3D) ultrasound power Doppler angiography to enhance differentiation between normal and pathologic ovaries.


METHODS
Twenty-seven cases with ovarian tumors were analyzed: 14 with invasive cancers and 13 with borderline tumors confirmed by surgery. The control subjects consisted of 53 healthy ovulating women. Ultrasound scans were done, and 3D volumes were analyzed with 3-/4-dimensional software for personal computers based on 3D vascularity indices: the vascularization index, flow index, and vascularization-flow index. A virtual spherical tissue sample of 1 cm3 was taken from the place of the highest vessel density contained completely within the contours of the ovary. Calculations for the whole solid volume were done for comparison.


RESULTS
Vascularity indices for both 1-cm3 spherical samples and whole dense parts of the ovaries were compared in the following groups: (1) ovarian tumors versus controls, (2) normal ovaries in the proliferative versus secretory phase, (3) invasive cancers versus borderline tumors, (4) invasive cancers versus normal ovaries, and (5) borderline tumors versus normal ovaries. Spherical 1-cm3 sampling achieved a higher degree of discrimination between the groups compared with the whole solid-part approach.


CONCLUSIONS
Spherical 1-cm3 sampling of ovarian tissue with 3D ultrasound power Doppler angiography is a sensitive and promising approach to differentiate between ovarian tumors and normal ovaries. It opens the possibility to implement objective computerized positioning, standardized comparison, and analysis of ovarian tumors.
Kudla
Marek J
MJ
Department of Obstetrics and Gynecology, Medical University of Silesia, Medykow 14, 40-780 Katowice, Poland. marekkudla@hotmail.com
Timor-Tritsch
Ilan E
IE
Hope
Joanie Mayer
JM
Monteagudo
Ana
A
Popiolek
Dorota
D
Monda
Susan
S
Lee
Catherine J
CJ
Arslan
Alan A
AA
D000328:Adult; D016022:Case-Control Studies; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D009361:Neoplasm Invasiveness; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012984:Software; D018709:Statistics, Nonparametric; D018608:Ultrasonography, Doppler