Color Doppler Prior to Surgery Highly Accurate in Distinguishing Cancerous and Benign Ovarian Masses
According to a recent article published in the International Journal of Gynecology and Obstetrics, the addition of color Doppler imaging (CDI) to standard sonography greatly improves the accuracy of distinguishing between cancerous and non-cancerous ovarian masses prior to surgery.
Ovarian cancer is the leading cause of death from gynecologic disease even though it only accounts for one-quarter of all cancers of the female genital tract in the U.S. Standard treatment for ovarian cancer includes surgery to remove as much cancer as possible. However, among younger women wishing to have children in the future, conservative surgical approaches for earlier stages of the disease may provide a cure while preserving childbearing capability.
Prior to surgery, it is important to distinguish between cancerous and benign ovarian masses and determine specific characteristics of the cancer; the surgeon uses this information to make decisions about the extent of surgery. Historically, sonography (ultrasound) was used to help determine these issues; accuracy with sonography alone, however, was substandard.
Researchers from India recently conducted a clinical trial to evaluate the benefits of adding CDI to standard gray/white sonography to help determine the nature of ovarian masses in women prior to surgery. The addition of color enhancement improves the visualization of blood flow through and around the mass; cancerous masses tend to have higher blood flow.
The trial included 50 women who underwent both standard sonography and CDI prior to surgery. Results were compared to pathological (laboratory) findings from their surgical specimens. CDI results were obtained in 26 women:
- Of these women, sensitivity (detection of masses) was 100% for CDI, while specificity (differentiation between cancerous and non-cancerous masses) was 85.7%.
- Sensitivity with sonography was 100%, while specificity was 71.4%.
- When taken together, readings from both CDI and sonography resulted in rates of 100% sensitivity and specificity.
The researchers concluded that the addition of CDI to sonography results in high accuracy of distinguishing between cancerous and non-cancerous ovarian masses prior to surgery. These results provide important information for the surgeon in terms of aggressiveness of the planned surgery, particularly for younger women who wish to have children in the future.
Reference: Tempe A, Singh S, Wadhwa L, Garg A. Conventional and color Doppler sonography in preoperative assessment of ovarian tumors. International Journal of Gynecology and Obstetrics. 2006; 92: 64-68.