Diagnostic Accuracy of Transvaginal Doppler Ultrasound in Differentiating Malignant and Benign Ovarian Masses

Abstract

Objective: To establish the diagnostic accuracy of transvaginal Doppler ultrasound in distinguishing malignant and benign ovarian masses, taking histopathology as gold standard. Methods: This cross-sectional study was conducted in the Department of Radiology at the Pakistan Institute of Medical Sciences, Islamabad. Total 100 patients of 25-55 years with a presence of ovarian mass on transabdominal ultrasonography were included. Patients with previous biopsy reports, chronic renal failure or a history of operations for ovarian mass were excluded. All patients under went transvaginal ultrasonography, and ovarian lesions were assessed for their site, dimensions, margins, echogenicity, soft tissue component, septations, and nodularity on grey scale. Power Doppler examinations followed, after which patients were sent to the Department of Gynecology for surgery, and specimens were sent for histopathological analysis. All the specimens were reviewed by experienced histopathologists and were labelled as benign or malignant. TVS Doppler findings were compared with the histopathology reports. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of transvaginal Doppler ultrasound were calculated. Results: Mean age of study patients was 43.16 ± 8.20 years. TVS Doppler ultrasound supported the diagnosis of malignant ovarian masses in 54 (54.0%) patients. Histopathology findings confirmed malignant ovarian tumor in 53 (53.0%) cases. Out of 54 TVS Doppler ultrasound positive patients, 50 patients were true positive and 04 were false positive. Out of 46, TVS Doppler ultrasound negative patients, 03 were false negative whereas 43 were true negative (p=0.0001).Overall sensitivity, specificity, positive predictive value(PPV), negative predictive value (NPV) and diagnostic accuracy of TVS Doppler ultrasound in differentiating malignant and benign ovarian tumors was 94.34%, 91.49%, 92.59%, 93.48% and 93.0% respectively. Conclusion: It is concluded that Transvaginal Doppler Ultrasonography is a non-invasive imaging modality of choice with high diagnostic accuracy in differentiating between benign and malignant ovarian tumors.