Objective: To evaluate whether transvaginal Doppler ultrasound is more valid than transvaginal sonography, magnetic resonance imaging (MRI), and CA 125 in differentiating malignant from benign ovarian tumors.
Methods: Sixty-three patients with ovarian tumors (36 benign and 27 malignant) were studied with transvaginal Doppler ultrasound before surgery. Blood flow velocity waveforms arising from intratumoral and/or tumor surface arteries were assessed by calculating the resistance index. Transvaginal B-mode sonography and MRI imaging examinations were also conducted. Serum CA 125 levels were measured.
Results: There was a significant difference between the resistance index value (0.692 +/- 0.188) in benign tumors and the value (0.503 +/- 0.107) in malignant tumors (P < .05). When 0.72 (mean of the malignant tumor resistance index values + 2 standard deviations) was considered as the cutoff value of the resistance index, the sensitivity and specificity of the resistance index in detecting malignant ovarian tumors were 92.6 and 52.8%, respectively. These values did not differ significantly from those with transvaginal sonography diagnosis (sensitivity 85.2%, specificity 69.4%). The resistance index sensitivity was significantly higher than those with MRI diagnosis (66.7%) and CA 125 levels (59.3%) (P < .05); however, the resistance index specificity was significantly lower than those with MRI diagnosis (97.1%) and CA 125 levels (91.7%) (P < .05).
Conclusion: Our results suggest that transvaginal Doppler ultrasound does not provide more useful diagnostic information than transvaginal sonography, MRI, and CA 125 for the differentiation of malignant from benign ovarian tumors.