Doppler evaluation in gynecological tumor recurrences

Abstract

Diagnosis of recurrent malignant disease in the abdomen and in the pelvis is a challenging problem. Because the survival of patients with disease recurrence is improved only in patients with small recurrent lesions, the detection of recurrences at a very early stage is of great importance. Clinical examination and tumor markers are used for the follow up of oncological patients; however, their diagnostic value is not very reliable. Computed tomography (CT) and magnetic resonance (MR) have been studied extensively and their diagnostic accuracy varies from 50 to 84%. Transrectal ultrasound has been used in monitoring recurrent female cancer with a diagnostic accuracy of 90.5% for pelvic lesions. However the ultrasound approach cannot be used to differentiate between radiation fibrosis and recurrent malignancy on the basis of tissue appearance. Color Doppler examination was proposed in the management of patients treated for rectal tumor. The aim of our study was to evaluate the ultrasound diagnostic accuracy in the detection of recurrent gynecological disease in a group of 350 patients, followed up every 3–6 months at our Department after surgical treatment of a pelvic gynecological malignancy. The ultrasound data have been compared to clinical examination, tumor markers and instrumental tools such as CT and MR. The usefulness of color Doppler velocimetry in the examination of recurrent malignant lesions has been analyzed. In a selected group of patients with small‐sized pelvic masses located in the central region of the pelvis, color Doppler analysis was able to differentiate recurrent vs. benign lesions.