Role of Preoperative Transvaginal Sonography, Color Flow Imaging, and Doppler Waveform Analysis in Predicting Lymph Node Metastases in Patients with Ovarian Cancer

Abstract

The aim of this prospective study was to assess the diagnostic accuracy of transvaginal sonography, color flow imaging, and Doppler waveform analysis of adnexal tumors in predicting lymph node metastases in women undergoing laparotomy for ovarian cancer. In 30 consecutive women undergoing pelvic and paraaortic lymphadenectomy due to ovarian cancer, the morphology of the adnexal mass was evaluated preoperatively with transvaginal sonography. Besides conventional gray-scale analysis as well as localization and intensity of angiogenesis, the resistance index (RI) was computed on the arteries detected with color flow imaging. There were 20 (66.7%) patients with negative and 10 (33.3%) patients with positive lymph nodes. The differences in maximal tumor diameter, maximal thickness of tumor wall, echographic structure, or presence of ascites between both groups of patients were not significant. There was no significant difference in the presence or absence of tumor vascularization between both groups of patients. In both groups of patients the mean value of the lowest RI was 0.37. Also, the difference in frequency of RI ≤ 0.40 between both groups of patients was not significant. Using conventional echographic analysis as well as color flow imaging and Doppler waveform analysis of adnexal tumors, according to the author's experience it was not possible to predict lymph node metastases in patients with ovarian cancer.