Obstet Gynecol Sci.  2024 Mar;67(2):227-234. 10.5468/ogs.23072.

Validity of ultrasound with color Doppler to differentiate between benign and malignant ovarian tumours

• Mahale N
• Kumar N
• Mahale A
• Ullal S
• Fernandes M
• Prabhu S

• KMID: 2553430
• DOI: http://doi.org/10.5468/ogs.23072

Abstract

Objective
To assess the utility of ultrasound and color Doppler and the Accuracy of International Ovarian Tumor Analysis (IOTA) group classification in the preoperative evaluation of ovarian neoplasms to assess benign or malignant histopathology in the diagnosis of ovarian tumors.
Methods
This observational longitudinal prospective analysis of 60 patients was performed over a period of 2 years (2017- 2019). The mean age of the patients was 43.75 years. Ultrasonography of ovarian masses were evaluated, and cancer antigen-125 (CA-125) levels were evaluated. Based on the IOTA classification, the B and M features of adnexal masses were studied. Color Doppler imaging was performed to evaluate the patterns of vascularity and indices.
Results
Sixty patients with 35 benign, 23 malignant, and two borderline lesions were included in the study. In malignant lesions, 17 women (73.9%) were above the age of 45. The CA-125 cut off was ≥35 internatioal units/mL. Based on the IOTA classification, 27/35 (77.1%) benign cases, were correctly identified as benign, 6/35 (17.1%) benign cases were incorrectly identified as malignant, and two (5.7%) were found to be inconclusive. In the malignant group, 17 of the 23 patients were identified as having malignancy. Color Doppler showed three (18.8%) benign tumors had a pulsatality index (PI) of <0.8 and 21 malignant tumors had a PI of <0.8. Four benign tumors had an resistive index (RI) of <0.6 and 100% of malignant tumors had an RI <0.6.
Conclusion
The IOTA classification is a reliable scoring system for adnexal masses, and color Doppler can help to minimize interobserver variation.

Keyword

Ultrasound; Doppler; Ovarian; Tumour; Morphology

Figure

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  Fig. 1 Serous cystadenoma with fine internal septae (<3 mm) and benign sonological features according to the IOTA classification. IOTA, International Ovarian Tumor Analysis.

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  Fig. 2 Serous cystadenocarcinoma of the ovary with thin and thick internal septae with malignant sonological features according to the IOTA classification. IOTA, International Ovarian Tumor Analysis.

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  Fig. 3 A right adnexal lesion with mixed solid and cystic areas showing low resistance vascularity consistent with Doppler features of malignancy. Ascites can be noted. Subsequent biopsy revealed mucinous cystadenocarcinoma.

Reference

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