Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
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.
How to cite this article:
Kiran Kumar Neelapu and V.N. Vamsi Krishna Setty. Diagnostic Role of Morphologic and Vascular Sonographic Criteria in Characterizing Ovarian Tumours.
DOI: https://doi.org/10.36478/makrjms.2022.125.130
URL: https://www.makhillpublications.co/view-article/1815-9346/makrjms.2022.125.130