OP21.08: Decidualized hypervascularized ovarian endometrioma in pregnancy: can it be distinguished from cancer to avoid surgery?

Abstract

institution between January 2003 and January 2006. Patients were not selected except for 3D-PD US availability. All women underwent 3D-PD US prior to surgery. Vascularization index (VI), Flow index (FI) and Vascularization-Flow index (VFI) from solid portions or papillary projections from the tumors were calculated using a virtual organ computer-aided analysis (VOCAL) program. In those tumors with more than one solid portion or papillary projection, the highest VI, FI and VFI values found were used for analysis. 2D Doppler (RI, PI and PSV) indexes were also obtained from vessels within the solid portions or papillary projections. The lowest RI and PI and the highest PSV (cm/sec) found were used for analysis. Definitive histological diagnosis was obtained in each case. Kruskal-Wallis test was used for comparisons. Results: Amongst 59 women, 12 had stage I primary cancers (5 lowmalignant potential tumors and 7 invasive tumors), 34 had advanced stage primary ovarian cancers and 13 had metastatic tumors to the ovary. Median VI and VFI were significantly higher in advanced stage tumors and metastatic tumors as compared with early stage tumors. No differences were found between advanced stage and metastatic cancers. No differences in RI, PI and PSV were found (Table 1) Conclusions: 3D-PD vascular derived indexes tend to higher in advanced stage and metastatic ovarian cancers as compared with early stage ovarian tumors. No differences were detected in 2D pulsed Doppler indexes.