Solid tumor on US favors metastatic ovarian cancer

(Ultrasound Review) According to Spanish researchers, it is difficult to differentiate primary ovarian carcinomas from metastatic ovarian tumors with grayscale and color Doppler ultrasound. A group from the Clínica Universitaria de Navarra in Pamplona reported on this issue in the Journal of Ultrasound in Medicine.

Their objective was to compare the grayscale and color Doppler characteristics of primary and metastatic ovarian tumors. The ultrasound findings of with 127 primary and 34 metastatic ovarian cancers were studied.

"Morphologic gray scale parameters assessed were bilaterality, tumor volume, echogenicity, and presence of septa, papillary projections, or solid areas," they reported. The color Doppler findings analyzed included "presence of blood flow, tumor blood flow location (central versus peripheral), subjective impression of blood flow amount (scanty, moderate, or abundant), lowest resistive index, lowest pulsatility index, and maximal peak systolic velocity (centimeters per second)."

Results demonstrated no statistical difference in "bilaterality, tumor volume, presence of septa, papillary projections or solid areas, presence of blood flow, tumor blood flow location, subjective impression of blood flow amount, lowest resistive index, lowest pulsatility index, and maximal peak systolic velocity." They discovered that metastatic carcinomas more often were solid tumors (47%) compared to primary carcinomas (26%).

Sonographically no differences in vascular features were demonstrated comparing primary and secondary ovarian tumors. They also found no differences in vascular features, as assessed by color Doppler sonography, between primary ovarian cancers and metastatic tumors. Because the angiogenic phenomena in primary and metastatic tumors, they were not surprised by this finding.

"In conclusion, we found that, although distinguishing between primary and metastatic ovarian malignancies is difficult with transvaginal gray scale and color Doppler sonography, a purely or predominantly solid tumor favors the diagnosis of a metastatic tumor rather than primary ovarian cancer," they determined.

Transvaginal gray scale and color Doppler sonography in primary ovarian cancer and metastatic tumors to the ovary
Alcázar, J. et al.
Department of obstetrics and gynecology, Clínica Universitaria de Navarra, Pamplona, Spain.
J Ultrasound Med 2003 March; 22:243-247

By Ultrasound Review
June 6, 2003

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