Transvaginal colour flow imaging: a possible new screening technique for ovarian cancer.

Bourne, Tom; Campbell, Stuart; Steer, C.V.; Whitehead, MI; Collins, W. P.

doi:10.1136/bmj.299.6712.1367

Cited by 296 publications

(99 citation statements)

References 13 publications

(1 reference statement)

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“…Doppler studies have presented some encouraging results in ovarian cancer (9,10). In endometrial cancer the need for Doppler examinations in order to detect early disease has not been as obvious.…”

Section: Discussionmentioning

confidence: 99%

Value of Uterine Artery Doppler in Endometrial Cancer

Flam

Hellström²,

Moberger

1995

Acta Oncologica

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Section: Discussionmentioning

confidence: 99%

Value of Uterine Artery Doppler in Endometrial Cancer

Flam

Hellström²,

Moberger

1995

Acta Oncologica

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“…While grey scale sonography is highly sensitive in identifying ovarian cancer, its diagnostic specificity has been poof. In an attempt to improve the specificity of ultrasound, the use of color Doppler sonography 2,[11][12][13]19,22,25,27 in addition to grey scale imaging has been proposed. In present study, 70 patients were evaluated using morphologic scoring system 14,21,26,28,30 proposed by JP Lerner et al and colour flow directed Doppler measurements were taken.…”

Section: Statistical Analysis Of Pulsatility Indexmentioning

confidence: 99%

“…The minority of patients discovered with early stage disease have 5year survival rate of 80-90%. There are various screening methods 15 for detection of ovarian cancer like bimanual pelvic examination, ultra sound examination (TVS and TAS) 3,5,7,10,23,28,30 with or without colour Doppler flow imaging 2,[11][12][13]17,19,22,25,27,29 and measurement of various circulating proteins like CA 125. 1,6,8,20 In analyzing the screening test by measuring CA 125 level and performing transvaginal ultrasound examination 26 appears to provide the highest specificity and positive predictive value for the detection of ovarian cancer.…”

mentioning

confidence: 99%

Sonomorphology and colour flow Doppler studies in differentiating between benign and malignant ovarian masses

Jothy

Padmasekar

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Ovarian cancer is the most frequent cause of death from Gynaecological malignancies in the world. Most patients with epithelial ovarian cancer are asymptomatic in early stage disease and usually present with stage III or IV disease. There are various screening methods for detection of ovarian cancer like bimanual pelvic examination, ultrasound examination (TVS and TAS) with or without color Doppler flow imaging and measurement of various circulating proteins like CA 125. The Purpose of a study is to determine optimal cut off point for a morphological scoring system and color flow directed Doppler values to differentiate benign and malignant ovarian masses.Methods: This study was done at Department of obstetrics and Gynaecology, Government Rajah Mirasudhar Teaching Hospital attached to Government Thanjavur Medical College, Thanjavur, Tamilnadu, India during the period of June – 2011 to October – 2012. This study consisted of 73 patients, 3 patients were not operated as they were not fit for surgery for medical reasons. Hence 70 patients were included in the study. A note was made of their main symptoms at admission, Parity, menopausal status, family history of carcinoma. Patients admitted with diagnosis of ovarian masses and clearly ovarian by sonomorphology and surgery were only included in this study. Morphological Score, RI and PI were calculated. All patients underwent exploratory laparotomy with surgical removal of the tumor. The final diagnosis obtained based on HPE were classified as either benign or malignant. The score of each mass and the Doppler values were assessed individually and in combination with regard to its relationship to final diagnosis.Results: In summary the resistance to flow measurement obtained by Doppler had a higher sensitivity and specificity compared to the morphological scoring system in differentiating benign and malignant ovarian masses. The combination of morphological score and Doppler Measurements improved the specificity positive predictive value for differentiating benign and malignant ovarian masses. Conclusions: The combination of ultrasound and Doppler values is better in differentiating benign from malignant ovarian masses. The cut off point for ultrasound guided morphological scoring system was 4 and Doppler velocimetry for differentiating benign and malignant ovarian masses was a RI of 0.55 and PI of 0.8.

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“…10 Evidence of neovascularization was sought in the masses and the vascular pulsatility index was calculated. Lack of neovascularization and a high pulsatility index were able to exclude the presence of invasive primary ovarian cancer.…”

Section: Transvaginal Color Flow Imagingmentioning

confidence: 99%

Laparoscopic Ovarian Cystectomy: Selection of Patients and Consequences of Rupture of Ovarian Malignancy

Rouzi

McComb

1997

Ann Saudi Med

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AA Rouzi, PF McComb, Laparoscopic Ovarian Cystectomy: Selection of Patients and Consequences of Rupture of Ovarian Malignancy. 1997; 17(3): 321-325 Operative laparoscopy is gaining popularity and widespread application in gynecology. In response to a survey on operative laparoscopy by the American Association of Gynecologic Laparoscopists, the laparoscopic management of ovarian cysts was the third most common procedure reported.1 Technological advances and appropriate training have allowed ovarian cystectomy to be performed laparoscopically. In this review, we assess the best available diagnostic means to select cases suitable for laparoscopic ovarian cystectomy to prevent inadvertent rupture of ovarian malignancy and to appraise the consequences of rupture of ovarian malignancy if it occurs. Diagnostic Tests and Selection of Patients History and Physical ExaminationHistorically, ovarian cancer has been described as occult disease with an insidious onset of nonspecific symptomatology. A disease of older age, the risk of ovarian malignancy is 12.1 times greater for the 60-69-year age range as compared with the 20-29-age range.2 And the overall risk of malignancy in an ovarian neoplasm increases from 13% in premenopausal women to 45% in postmenopausal women. The use of a physical examination to differentiate benign from malignant disease is based upon certain characteristics, including bilaterality, presence of cystic/solid components, mobility of the pelvic structures, irregularity of the cyst surface, ascites and cul-de-sac nodularity.3 However, these characteristics are nonspecific and some (cystic/solid components or irregularities of the cyst) are best addressed ultrasonographically. Tumor MarkersCirculating tumor markers are used increasingly in the diagnosis and management of gynecologic malignancy. A detailed discussion of tumor markers is beyond the focus of this review. The most commonly used marker for epithelial ovarian cancer is CA 125, a tumor-associated antigen that can be recognized by the specific monoclonal antibody and that is present in 80% of all patients with ovarian cancer. Forty percent of women with Stage I ovarian cancer will have elevated levels. 4 However, it can also be elevated in other physiological circumstances (menstruation and early pregnancy), in benign gynecologic conditions (endometriosis) and with other malignancies (pancreas, stomach, colon and rectum).To use CA 125 for identifying malignant pelvic masses, O'Connell et al. constructed a receiver operator characteristic (ROC) curve and determined that a cutoff of 35 U/mL achieves a sensitivity of 100%, a negative predictive value of 100%, a specificity of 43% and a positive predictive value of 60%. 5 The ROC curve describes the accuracy of a test over a range of cutoff points by depicting the tradeoff between sensitivity and specificity. It can also compare the validity of different diagnostic tests. In this series, however, it is necessary to consider the possibility of selection bias because of the high clinical suspici...

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Transvaginal colour flow imaging: a possible new screening technique for ovarian cancer.

Cited by 296 publications

References 13 publications

Value of Uterine Artery Doppler in Endometrial Cancer

Value of Uterine Artery Doppler in Endometrial Cancer

Sonomorphology and colour flow Doppler studies in differentiating between benign and malignant ovarian masses

Laparoscopic Ovarian Cystectomy: Selection of Patients and Consequences of Rupture of Ovarian Malignancy

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