Detection of central pelvic recurrent disease with transvaginal color Doppler ultrasound in women treated for gynecological malignancy

Abstract

Objective: To evaluate color Doppler characteristics of small recurrent tumors detected within the central pelvis in follow-up patients treated for gynecological malignancy.

Patients and methods: A prospective study was performed on 340 patients who were being monitored following treatment for gynecological malignancies. A selected group of 27 patients, with small pelvic masses located in the central region of the pelvis, underwent a color Doppler examination. A subjective assessment of the vascularization (vascular score), the lowest resistance index (RI), the highest peak velocity (PSV) and the highest time averaged maximum velocity (TAMXV) of the vessels detected within the lesion were analyzed.

Results: In 16 patients the pelvic mass was found to be benign while in 11 patients a malignant recurrence was diagnosed. Gray-scale examination could not differentiate between benign and malignant lesions. The color score of tumor recurrences was significantly higher in comparison to that in benign lesions (color score 3 in 54% vs. 0%, P < 0.005). The malignant lesions showed significantly lower mean values of RI and significantly higher mean values of PSV and TAMXV when compared with benign lesions (0.39 +/- 0.09 vs. 0.81 +/- 0.22, P < 0.0001; 19.3 +/- 4.7 vs. 10.5 +/- 5.6 cm/s, P < 0.0001; 8.9 +/- 3.7 vs. 4.3 +/- 2.7 cm/s, P < 0.005).

Conclusions: Color Doppler analysis added to transvaginal gray-scale ultrasonography seems to be a helpful tool in the diagnosis of recurrent tumors in the central region of the pelvis.