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Does Doppler analysis of musculoskeletal soft-tissue tumours help predict tumour malignancy?
J F Griffith1, D P N Chan, S M Kumta
1Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, Shatin, New Territories, China. griffith@ruby.med.cuhk.edu.hk
Aim:
To investigate whether analysing vascularity of soft-tissue tumours on ultrasound assists differentiating benign from malignant tumours.
Materials And Methods:
One hundred and forty-eight vascular soft-tissue tumours in 148 patients (88 males, mean age 45.6 years) were studied. Final diagnosis was established histologically in 95 (64%) of cases. For each tumour, three-colour Doppler imaging features (vascularity, vascular density, vascular organization) and 13 pulsed Doppler (spectral analysis) parameters were assessed. Data analysis was performed to isolate optimal discriminatory criteria for differentiating benign from malignant tumours.
Results:
Significantly more benign soft-tissue tumours had an organized vascular pattern on colour Doppler imaging. If the vascular pattern is organized, this is a good indicator of tumour benignity. However, this pattern was apparent in less then one-third of the soft-tissue tumours. Benign tumours also had significantly higher minimum end diastolic velocity (EDVmin) and lower mean ratio of resistive index (RImean) than malignant soft-tissue tumours, though considerable overlap existed between the two groups.
Conclusion:
Colour Doppler imaging analysis of soft-tissue tumours is of limited value when differentiating benign from malignant tumours. If an organized vascular pattern is present, the tumour is more likely to be benign. Flow characteristics were not specific enough to be applicable in clinical practice.
