Accuracy of ultrasonography and color Doppler in diagnosis of ovarian masses and its correlation with histopathological findings

Kariman Ghazal; Jihad El Hasan; Hanine Hijasi; Ev Koulaima

doi:10.18203/2320-1770.ijrcog20205214

Authors

Kariman Ghazal Department of Obstetrics and Gynecology, Lebanese University, Lebanon Department of Obstetrics and Gynecology, Rafik al Hariri Hospital University Medical Center, Beirut, Lebanon
Jihad El Hasan Department of Obstetrics and Gynecology, Lebanese University, Lebanon Department of Obstetrics and Gynecology, Al Zahraa Hospital University Medical Center, Beirut, Lebanon
Hanine Hijasi Department of Obstetrics and Gynecology, Rafik al Hariri Hospital University Medical Center, Beirut, Lebanon
Ev Koulaima Department of Obstetrics and Gynecology, Al Zahraa Hospital University Medical Center, Beirut, Lebanon

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20205214

Keywords:

Ovarian cancer, Ultrasonography, Doppler

Abstract

Background: Ovarian cancer is often diagnosed in advanced stages due to the absence of specific symptoms. Yet, there are no reliable screening tests for ovarian malignancies. However, improvements in imaging techniques such as ultrasonography and color Doppler increased the probability of early detection. The purpose of this study was to compare between the ultrasonographic and color Doppler findings of ovarian masses with their histopathological diagnosis.

Methods: A retrospective review was performed on patients between January 2017 and January 2020 diagnosed to have an ovarian mass. The eligible patients were subsequently divided into 2 groups: group A included patients who had abdominal and vaginal ultrasound in order to assess the morphology of the ovarian neoformation, and group B included patients whose ovarian masses were evaluated by color Doppler in addition to transabdominal ultrasound in order to identify their vascularization as well as their morphology.

Results: A total of 74 patients were included in the study with 42 patients in group A and 32 patients in group B. Of the 42 adnexal masses studied in group A, 8 (19.0%) were malignant, 33 (78.6%) were benign and 1 (2.4%) was borderline. Ultrasound had a sensitivity of 89.0%, a specificity of 100.0%, a positive predictive value (PPV) of 100.0%, a negative predictive value (NPV) of 97.0% and accuracy of 97.0%. On the other hand, of the 32 masses examined in Group B, 7 (21.9%) were malignant, 23 (71.9%) were benign and 2 (6.3%) were borderline. Color doppler had a sensitivity of 55.6%, a specificity of 95.5%, a PPV of 83.0%, a NPV of 84.0% and accuracy of 84.0%. When using color Doppler in addition to morphology score, the sensitivity was 100.0%, specificity 95.5%, PPV 90.0%, NPV 100.0% and accuracy 96.6%.

Conclusions: Ultrasound combined to color Doppler improves the diagnosis of ovarian tumors with accurately detecting malignant from benign ones

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References

Global Cancer Observatory. Lyon: International Agency for Research on Cancer.

Cabasag CJ, Butler J, Arnold M, Rutherford M, Bardot A, Ferlay J, et al. Exploring variations in ovarian cancer survival by age and stage (ICBP SurvMark-2): A population-based study. Gynecol Oncol. 2020;157:234-4.

Chandra A, Pius C, Nabeel M, Nair M, Vishwanatha JK, Ahmad S, et al. Ovarian cancer: Current status and strategies for improving therapeutic outcomes. Cancer Med. 2019;8:7018-31.

Momenimovahed Z, Tiznobaik A, Taheri S, Salehiniya H. Ovarian cancer in the world: epidemiology and risk factors. Int J Women Health. 2019;11:287-99.

Abramowicz JS, Condous G, Timmerman D. Ovarian mass-differentiating benign from malignant. Why the International Ovarian Tumour Analysis rules should be implemented in Australasia. Australas J Ultrasound Med. 2018;21:121-4.

Henderson JT, Webber EM, Sawaya GF. Screening for ovarian cancer: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2018;319:595-606.

Jacobs IJ, Menon U. Progress and challenges in screening for early detection of ovarian cancer. Mol Cell Proteomics. 2004;3:355-66.

Niazi M. Transabdominal vs transvaginal sonography-comparison in pelvic pathologies. JRMC. 2015;19:223-6.

Gangopadhyay S, Chakraborty P, Singh A. How successful is color flow mapping and pulsed Doppler studies in predicting histologically confirmed benign and malignant adnexal masses in perimenopausal women. Int J Reprod Contracept Obstet Gynecol 2017;6:5440-7.

Blanco EC, Pastore AR, Fonseca AM, Carvalho FM, Carvalho JP, Pinotti JA. Color Doppler sonography with contrast in the differentiation of ovarian tumors. Rev Hosp Clín Fac Med S Paulo. 2003;58:185-92.

Sehgal N. Efficacy of color doppler ultrasonography in differentiation of ovarian masses. J Midlife Health. 2019;10:22-8.

Tongsong T, Wanapirak C, Neeyalavira V, Khunamornpong S, Sukpan K. E-flow doppler indices for prediction of benign and malignant ovarian tumors. Asian Pac J Cancer Prev. 2009;10:139-42.

Sassone AM, Timor-Tritsch IE, Artner A, Westhoff C, Warren WB. Transvaginal sonographic characterization of ovarian disease: evaluation of a new scoring system to predict ovarian malignancy. Obstet Gynecol 1991;78:70-6.

Khurana I, Satia MN. Preoperative evaluation of ovarian masses with color Doppler and its correlation with pathological finding. Int J Reprod Contracept Obstet Gynecol. 2016;5:2084-92.

Shah D, Shah S, Parikh J, Bhatt CJ, Vaishnav K, Bala DV. Doppler ultrasound: a good and reliable predictor of ovarian malignancy. J Obstet Gynecol India. 2013;63:186-9.

Khalaf LM, Desoky HH, Seifeldein GS, Al-Sharkawy M, Sayed MM, Ahmed S, et al. The diagnostic efficacy of Gynecology Imaging Reporting and Data System (GI-RADS): single-center prospective cross-sectional study. Egypt J Radiol Nucl Med. 2019;50:1-9.

Fischerova D, Zikan M, Dundr P, Cibula D. Diagnosis, treatment, and follow-up of borderline ovarian tumors. Oncologist. 2012;17:1515-33.

Kurjak A, Kupesic S, Shalan H, Jukic S, Kosuta D, Ilijas M. Uterine sarcoma: a report of 10 cases studied by transvaginal color and pulsed Doppler sonography. Gynecol Oncol. 1995;59:342-6.