Morphological Scoring System , Color Doppler Sonography , and Serum CA-125 in the Assessment of Ovarian Cancer

Park, S W; Kim, J U; Park, Y W; Choi, H M; Kim, Y T; Cho, J S

Abstract

Ovarian cancer is a silent disease with few symptoms. Because early detection of ovarian cancer is difficult, most cases are diagnosed at an advanced stage. To determine whether an ovarian tumor is malignant or not, various diagnostic procedures have been used including physical examination, computed tomography scan, ultrasound, and tumor markers such as CA-125. The morphological scoring system to predict ovarian malignancy thru transvaginal sonography is based on size, wall thickness, internal wall structure and septation with respect to the precise determination of malignancy. Transvaginal Doppler ultrasound with color flow imaging allows closer positioning of the probe to a particular tumor and visually reflects the state of blood flow of an ovarian tumor. OBJECTIVE: To compare color and pulsed Doppler sonography with the morphological scoring system and serum CA-125 levels in establishing an accurate preoperative diagnosis of adnexal mass. To evaluate the availability of conventional sonography in combination with color Doppler sonography and CA-125. METHOD: Medical records of 42 patients referred with preexisting adnexal lesion were reviewed etrospectively by comparing preoperative ultrasonic data (morphological scoring system and color and pulsed Doppler findings) with serum CA-125 levels.
RESULTS
Fourty-two masses were removed surgically, and confirmed as 29 malignancies and 13 benign tumors. The morphological scoring system showed a higher sensitivity (86.2%) than Color Doppler Sonography(CDS) or CA-125. CDS revealed the highest specificity (90.9%) in distinguishing malignant from benign ovarian tumors.
CONCLUSION
The morphological scoring system is the basic method for predicting ovarian malignancy. The morphological scoring system used in combination with CA-125 and CDS may improve the accuracy of predicting ovarian malignancy.