Role of transvaginal ultrasound color flow imaging and Doppler waveform analysis in differentiating between benign and malignant ovarian tumors.

This study was undertaken to assess the usefulness of ultrasound color flow imaging and Doppler waveform analysis in differentiating between benign and malignant ovarian tumors. From 1991 to 1993, 146 patients with 156 ovarian tumors underwent transvaginal scanning with color flow imaging and Doppler waveform analysis prior to surgery. All the ovarian tumors were removed surgically and confirmed histologically. The sensitivity and specificity of color flow imaging in identifying malignant ovarian tumors was 76.5% and 68%, respectively. Positive and negative predictive values were 40% and 91.2%, respectively. The addition of Doppler waveform analysis failed to produce statistically better results. Seven of the eight cases of ovarian cancer were missed by color Doppler. There were no solid areas present and malignancy was not suspected. Both modalities also failed to identify any case of ovarian cancer presenting as a simple cyst.