Does three-dimensional power Doppler ultrasound  improve the diagnostic accuracy for the prediction of  adnexal malignancy?
OBJECTIVE
The aim of the present study was to investigate the diagnostic accuracy of three-dimensional power Doppler ultrasound (3DPD) in the differentiation between benign and malignant adnexal masses and evaluate 3DPD for assessing malignancy in comparison with two-dimensional transvaginal gray-scale sonography (2DTVS), magnetic resonance imaging (MRI) and positron emission tomography (PET).


METHODS
Thirty-six patients with suspicious adnexal masses were included in this study. 2DTVS and 3DPD were performed preoperatively. MRI and PET examinations were also carried on within two weeks of initial sonography. All the results of diagnostic imaging techniques were evaluated separately. Final diagnosis was confirmed by the postoperative histopathology. The mature cystic teratomas and endometriomas with typical gray-scale sonographic appearance were excluded from the study.


RESULTS
Of the 36 patients, 25 had a malignancy, 5 had a borderline tumor, and 6 had a benign mass. Sensitivity of 2DTVS, 3DPD, MRI and PET were 96.7%, 76.7%, 96.7% and 83.3%, respectively. The sensitivity of 2DTVS was as high as that of MRI, and both of them were significantly higher than those of 3DPD and PET, respectively. There were no significant differences both in specificity and accuracy among these 4 techniques.


CONCLUSIONS
3DPD did not improve the diagnostic accuracy for the prediction of malignancy in adnexal masses. 2DTVS may still remain an important modality for the prediction of adnexal malignancy.
Dai
Shu-Yan
SY
Department of Perinatology and Gynecology, Kagawa University School of Medicine, Ikenobe, Miki, Kagawa, Japan.
Hata
Kohkichi
K
Inubashiri
Eisuke
E
Kanenishi
Kenji
K
Shiota
Atsuko
A
Ohno
Masayuki
M
Yamamoto
Yuka
Y
Nishiyama
Yoshihiro
Y
Ohkawa
Motoomi
M
Hata
Toshiyuki
T
D000291:Adnexal Diseases / Q000175:diagnosis* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005185:Fallopian Tube Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D005260:Female; D005833:Genital Neoplasms, Female / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler / Q000379:methods*