Sonographic and Doppler predictors of malignancy in ovarian lesions

Abstract

Background: To determine the best sonographic (US) and/or Doppler features that the radiologist can use as predictors or risk factors for ovarian malignancy Results: Among the examined 156 ovarian lesions, there were 53 malignant and 103 benign lesions. Most of the malignant ovarian lesions were noted in older age than in benign lesions p < 0.001. Majority of the malignant lesions had non-hyperechoic solid component (92.5%); it had the highest sensitivity of 92.5%, specificity of 97%, accuracy of 94.8%, positive predictive value of 94%, negative predictive value of 96%, and AUC of 0.94 in discrimination between benign and malignant ovarian lesions. The presence of papillary projection, the absence of wall definitions and thick wall, and thick septation were noted in 83%, 81%, and 53.8% of the malignant ovarian lesions respectively. Color flow Doppler shows neovascularity in 88.7% of the malignant lesions, 73.6% of them has central blood flow. The multivariate regression analysis revealed that the presence of non-hyperechoic solid component, new vascularity with central location of the blood flow, papillary projection, thick septa, and old age were the most significant parameters in predicting ovarian cancer in decreasing order of frequency according to their odds ratio (19.45, 7.55, 4.56, 3.45, and 1.45, respectively). Conclusions: The non-hyperechoic solid component, new vascularity with central location of the blood flow, papillary projection, and thick septa were the most significant and consistent US and Doppler predictors of ovarian malignancy in addition to one clinical feature which is the old age ≥ 52 years.

Comparative Study of Usg B-Mode and Doppler in Evaluation of Ovarian Mass Lesions

“…On adding doppler ndings, 72.8% were characterised as benign and 27.2% as [5] malignant. This was comparable with the studies done by Garg et al in [6] 2017 and Khalaf et al in 2018.…”

“…Among cystic and mixed lesions, thick septations, papillary projections and solid components were found in 22%, 34% and 33% cases respectively. This was comparable with the observation made by [6] Khalaf et al in 2018, where thick septations, papillary projections and solid components were observed respectively in 20%, 32.7% and 36.6% of their cases. The solid lesions in our study were well-dened, heterogeneous with foci of calcications and 1 showing necrosis.…”

Diagnostic Performances of Ultrasound-Based Models for Predicting Malignancy in Patients with Adnexal Masses

“…Previous studies have also shown that vascularized tissue, thick septations, and papillary projections were the most important and consistent ultrasound and Doppler predictors of ovarian malignancy [24,25]. Upon the analysis of our study population, the presence of papillae with blood flow and irregular cyst walls were significantly associated with a 20-fold and 10-fold increase in the likelihood of a malignant lesion.…”

Efficacy of Doppler Ultrasound in Detection of Ovarian Malignancy

“…Color doppler with spectral analysis such as PI and RI improves characterization of ovarian neoplasm by means of quantitative blood flow measurements obtained from tumor vessels. 10 It is the matter of the fact that low impedance to blood flow with high velocity is indicative of malignancy whereas moderate to high impedance to blood flow is suggestive of benign tumors. 92 % of malignant tumors in Taori Kb et al study showed blood flow; conversely absence of blood flow is equally important that suggest the benign nature of tumor.…”