Three-dimensional power Doppler ultrasound in ovarian cancer and its correlation with histology

The aim of this study was to evaluate and quantify intraovarian blood flow with 3D power Doppler histogram analysis before surgical intervention in women suspected of having ovarian carcinoma and to determine the correlation with histology findings.

A prospective study was designed and 17 consecutive patients undergoing oophorectomy were included. Two groups of women were evaluated: high-risk women for ovarian pathologies and low-risk women with no known ovarian disease scheduled for bilateral oophorectomy for nonmalignant related pathology. Transvaginal ultrasound was performed using 2D, 3D-power Doppler ultrasound and histogram techniques. Four main parameters were evaluated: vascularization index (VI), flow index (FI), vascularization-flow index (VFI) and mean grayness (MG). Histological confirmation of the findings was done in all patients. Data were analyzed by the Mann-Whitney U test with P<0.05 considered as significant.

Ultrasound scanning was performed for a total of 24 ovaries: 9 ovaries with cancer and 15 controls. There were no significant differences between the groups in all four histogram measurements: FI, VI, VFI and MG. There were no differences between the groups regarding ultrasound findings of free fluid in pelvis (16.7% in women with malignancy, 18.2% in women without ovarian malignancy; P=0.938) and the presence of complex ovarian cyst (83.8% in women with malignancy, 36.4% in women without ovarian malignancy; P=0.131).

No significant differences were noted between benign and malignant ovaries in our population in all four indices of vascularity and perfusion of 3D power Doppler. Further large prospective studies should evaluate the significance of 3D power Doppler using histogram analysis in the early detection of ovarian cancer.