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Limited contribution of Doppler velocimetry to the differential diagnosis of extrauterine pelvic tumors

Valentin, Lil LU ; Sladkevicius, Povilas LU and Marsal, Karel LU (1994) In Obstetrics and Gynecology 83(3). p.425-433
Abstract
OBJECTIVE: To compare the ability of transvaginal color and spectral Doppler and that of gray-scale ultrasound examination to discriminate between benign and malignant extrauterine pelvic tumors. METHODS: One hundred forty-nine consecutive women scheduled for laparotomy because of an extrauterine pelvic mass underwent ultrasound examination, including color and spectral Doppler techniques, within 8 days before a planned operation. Based on the gray-scale ultrasound image, each tumor was classified as a unilocular cyst, multilocular cyst, unilocular cyst with solid parts, multilocular cyst with solid parts, or solid tumor. Doppler signals of the maximum blood flow velocity of tumor vessels were evaluated for pulsatility index (PI) and peak... (More)
OBJECTIVE: To compare the ability of transvaginal color and spectral Doppler and that of gray-scale ultrasound examination to discriminate between benign and malignant extrauterine pelvic tumors. METHODS: One hundred forty-nine consecutive women scheduled for laparotomy because of an extrauterine pelvic mass underwent ultrasound examination, including color and spectral Doppler techniques, within 8 days before a planned operation. Based on the gray-scale ultrasound image, each tumor was classified as a unilocular cyst, multilocular cyst, unilocular cyst with solid parts, multilocular cyst with solid parts, or solid tumor. Doppler signals of the maximum blood flow velocity of tumor vessels were evaluated for pulsatility index (PI) and peak systolic and time-average maximum velocity. The results of gray-scale imaging and Doppler velocimetry were related to the final diagnosis, which in most cases was based on histology of the specimen. RESULTS: None of the 88 unilocular or multilocular cysts without solid parts were malignant, compared to 28 malignancies (46%) among the 61 tumors with solid components. The PI was significantly lower, and the peak systolic and time-average maximum blood flow velocities significantly higher, in the malignant than in the benign tumors. However, this was true only of the multilocular cysts with solid parts; the PI and blood flow velocity results overlapped completely between benign and malignant solid tumors. According to receiver operating characteristic curves, the ultrasound morphology of the tumors was a better discriminator between benign and malignant tumors than any of the Doppler variables. Ultrasound morphology correctly identified all the malignant tumors, with a false-positive rate of 27%. Discrimination was slightly improved if PI and blood flow velocity were used for discriminating between benign and malignant multilocular cysts with solid parts. With this approach, all the malignant tumors were detected with a false-positive rate of 17-23%, depending on which Doppler variable and which cutoff level was used. CONCLUSION: The present technique of Doppler velocimetry has a limited contribution to the differential diagnosis of extrauterine pelvic tumors. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Obstetrics and Gynecology
volume
83
issue
3
pages
425 - 433
publisher
Lippincott Williams & Wilkins
external identifiers
  • scopus:0028176033
ISSN
1873-233X
language
English
LU publication?
yes
id
4b6a9a80-4be0-4ba2-b222-1a4be2b476d3 (old id 1108405)
date added to LUP
2008-07-24 09:24:01
date last changed
2017-01-01 06:42:49
@article{4b6a9a80-4be0-4ba2-b222-1a4be2b476d3,
  abstract     = {OBJECTIVE: To compare the ability of transvaginal color and spectral Doppler and that of gray-scale ultrasound examination to discriminate between benign and malignant extrauterine pelvic tumors. METHODS: One hundred forty-nine consecutive women scheduled for laparotomy because of an extrauterine pelvic mass underwent ultrasound examination, including color and spectral Doppler techniques, within 8 days before a planned operation. Based on the gray-scale ultrasound image, each tumor was classified as a unilocular cyst, multilocular cyst, unilocular cyst with solid parts, multilocular cyst with solid parts, or solid tumor. Doppler signals of the maximum blood flow velocity of tumor vessels were evaluated for pulsatility index (PI) and peak systolic and time-average maximum velocity. The results of gray-scale imaging and Doppler velocimetry were related to the final diagnosis, which in most cases was based on histology of the specimen. RESULTS: None of the 88 unilocular or multilocular cysts without solid parts were malignant, compared to 28 malignancies (46%) among the 61 tumors with solid components. The PI was significantly lower, and the peak systolic and time-average maximum blood flow velocities significantly higher, in the malignant than in the benign tumors. However, this was true only of the multilocular cysts with solid parts; the PI and blood flow velocity results overlapped completely between benign and malignant solid tumors. According to receiver operating characteristic curves, the ultrasound morphology of the tumors was a better discriminator between benign and malignant tumors than any of the Doppler variables. Ultrasound morphology correctly identified all the malignant tumors, with a false-positive rate of 27%. Discrimination was slightly improved if PI and blood flow velocity were used for discriminating between benign and malignant multilocular cysts with solid parts. With this approach, all the malignant tumors were detected with a false-positive rate of 17-23%, depending on which Doppler variable and which cutoff level was used. CONCLUSION: The present technique of Doppler velocimetry has a limited contribution to the differential diagnosis of extrauterine pelvic tumors.},
  author       = {Valentin, Lil and Sladkevicius, Povilas and Marsal, Karel},
  issn         = {1873-233X},
  language     = {eng},
  number       = {3},
  pages        = {425--433},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Obstetrics and Gynecology},
  title        = {Limited contribution of Doppler velocimetry to the differential diagnosis of extrauterine pelvic tumors},
  volume       = {83},
  year         = {1994},
}