(Ultrasound Review) For patients with epithelial ovarian cancer, ultrasound-derived intratumoral peak systolic velocity (PSV) could be a preoperatively pertinent prognostic predictor of survival. The study, reported in the September issue of Ultrasound in Obstetrics and Gynecology, found that stage of disease, presence of residual disease, and PSV all were associated with a poor prognosis.
Dr. K. Hata from Shimane Medical University, Japan, and colleagues performed color Doppler and pulsed Doppler analysis in 49 women with epithelial ovarian cancer within 24 hours prior to exploratory surgery.
The researchers used color Doppler to identify areas of high vascularity and pulsed-wave Doppler then was used to obtain spectral waveforms. The resistive index, PSV and time-averaged maximum velocity all were calculated. Previous research has demonstrated an association between tumor angiogenesis and high PSV.
All scans were performed using a 5 MHz transvaginal transducer and an Aloka SSD-680 or Aloka SSD-2000. Five waveforms were obtained and an average was calculated. Ultrasound findings were compared with a number of factors including age, stage of disease, residual tumor, histology subtype, thymidine phosphorylase (TP) expression and microvessel count.
Tissue specimens were taken from the region of tumor with the lowest resistive index. According to the authors, "histological grade, TP expression, apototic index and microvessel count were significantly associated with PSV." For example, the median PSV for poorly differentiated tumor was 26.8 cm/s compared with 13.8 cm/s for tumors with low malignant potential.
They noted that standardization of Doppler ultrasound techniques when studying the pelvis is a common difficulty, and suggested that an expert technique and thorough understanding of Doppler physics and pelvic anatomy was necessary to minimize errors. Presently they have no explanation for the association between increased PSV and the pathophysiology that determines the prognosis of epithelial ovarian cancer. They hope to find an answer to this question in their continuing research into the disease.
Prognostic significance of ultrasound derived intratumoral peak systolic velocity in epithelial ovarian cancerHata, K et al
Dept of obstetrics and gynecology, Shimane Medical University, Izumo, Japan
Ultrasound Obstet Gynecol 2002 August; 20:186-191
By Ultrasound Review
November 14, 2002
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