@article{MAKHILLRJMS202216431876,
    title = {Diagnostic Role of Morphologic and Vascular Sonographic Criteria in Characterizing Ovarian Tumours},
    journal = {Research Journal of Medical Sciences},
    volume = {16},
    number = {4},
    pages = {125-130},
    year = {2022},
    issn = {1815-9346},
    doi = {makrjms.2022.125.130},
    url = {https://makhillpublications.co/view-article.php?issn=1815-9346&doi=makrjms.2022.125.130},
    author = {V.N. Vamsi and},
    keywords = {Ovarian tumour, colour doppler, resistive index, pulsatility index, morphologic criteria, ultrasonography, adnexal mass differentiation},
    abstract = {Ovarian cancer remains a major cause of gynaecologic malignancy‐related
mortality worldwide. Early and accurate differentiation of benign from
malignant ovarian masses is essential for appropriate surgical planning
and referral. While gray‐scale ultrasonography provides valuable
morphological information, Colour and Spectral Doppler imaging can add
physiologic insights by assessing tumour vascularity and impedance to
blood flow. Aim of the study was to evaluate the diagnostic efficacy of
combined morphologic and vascular sonographic (Colour and Spectral
Doppler) criteria in differentiating benign and malignant ovarian tumours
and to correlate these findings with histopathology. This prospective
observational study was conducted in the Department of Radiology over
a period of 12 months on 50 female patients presenting with ovarian or
adnexal masses. All patients underwent gray‐scale ultrasonography
followed by Colour and Spectral Doppler assessment. Morphologic
parameters (size, wall thickness, septations, papillary projections,
echogenicity, ascites) and vascular parameters (pattern of flow, Resistive
Index [RI], Pulsatility Index [PI]) were documented. The lowest RI and PI
from the most prominent intratumoral vessel were recorded. A cut‐off of
RI < 0.4 and PI < 1.0 was used to indicate malignancy. Histopathological
diagnosis following surgery or biopsy served as the gold standard.
Statistical analysis was performed using SPSS version 25.0, with
sensitivity, specificity, predictive values, and ROC curves calculated.
Out of 50 cases, 32 (64%) were benign and 18 (36%) malignant on
histopathology. Peripheral vascularity predominated in benign lesions
(65.6%), while central/mixed flow was typical of malignant lesions
(83.3%). The mean RI and PI values were 0.68 ± 0.07 and 1.35 ± 0.14 for
benign, and 0.40 ± 0.06 and 0.82 ± 0.10 for malignant lesions, respectively
(p < 0.001). Using morphology alone, ultrasound achieved 78.9%
sensitivity, 90.3% specificity, and 86.0% accuracy. When Doppler criteria
were added, diagnostic accuracy improved to 92.0% (sensitivity 88.9%,
specificity 93.7%). ROC analysis demonstrated an AUC of 0.96 for
combined morphologic and Doppler criteria. Combined morphologic and
vascular sonographic assessment significantly enhances diagnostic
accuracy in differentiating benign from malignant ovarian tumours.
Incorporating Doppler indices (RI, PI) with structural features yields high
sensitivity and specificity, supporting its integration into standardized
evaluation systems such as IOTA Simple Rules and O‐RADS US for
improved preoperative triage.}
    }