Diagnostic Accuracy of Doppler in Identifying Malignant Ovarian Neoplasms Taking Histopathology as Gold Standard

Abstract

Objective: To determine the diagnostic accuracy of Color Doppler and Spectral Doppler in identifying malignant ovarian neoplasm using histopathology as the gold standard. Study Design: Cross section validation Place and Duration of Study: The study was carried out in Radiology Department in collaboration with the Pathology department at Rawalpindi Medical University and Allied Hospitals, Rawalpindi, for a period of 11 months, from May 2015 to April 2016. Material and Methods: Patients with a clinically palpable ovarian mass or ovarian masses detected incidentally on gray scale ultrasound, who underwent surgery or biopsy within one month of Doppler examination were selected by consecutive (non-probability) sampling. A total of 153 patients were then examined by Duplex ultrasonography. Flow score, Resistive index (RI) and Pulsatility index (PI) were recorded for each patient. Postsurgical histopathology of the excised ovarian mass or tissues as benign or malignant was collected and diagnostic efficacy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of Duplex USG in identifying malignant ovarian neoplasms was calculated. Results: Diagnostic accuracy of Doppler ultrasound in identifying malignant ovarian neoplasm has been calculated as 95.4%, sensitivity 86.2%, specificity 97.58%, positive predictive value 89.28% and negative predictive value 96.8% in comparison with the gold standard of histopathology. Conclusion: The study concludes that Doppler ultrasound is a reliable and dependable technique in the diagnosis of malignant ovarian neoplasm, however though Doppler parameters have good accuracy histopathology remains the gold standard due to limitations of the Doppler modality in pelvic inflammatory lesions.

Keywords

• biopsy, doppler ultrasound, malignant ovarian neoplasm, pulsatility index, resistive index.