Journal of Ultrasound in Medicine, Vol 12, Issue 7 387-393, Copyright © 1993 by American Institute of Ultrasound in Medicine
Screening for ovarian cancer in women with breast cancer with transvaginal sonography and color flow imaging
Z. Weiner, D. Beck, M. Shteiner, R. Borovik, M. Ben-Shachar, E. Robinzon and J. M. Brandes
Department of Obstetrics and Gynecology, Rambam Medical Center, Haifa, Israel.
The aim of the present study was to determine the efficacy of transvaginal
color flow imaging as a screening tool for ovarian cancer. Six hundred
patients with previous breast carcinoma were screened for ovarian cancer.
Screening was performed using transvaginal sonography with color flow
imaging. Serum CA 125 levels were measured in patients with abnormal
sonographic findings. Eighty-three percent of the ovaries were detected in
the premenopausal patients by ultrasonographic scanning and only 26% of the
ovaries were detected in the postmenopausal patients. Intraovarian blood
vessels were detected in 11% of the premenopausal women. The PI was less
than 1 in 80% of these ovaries, but, on repeated examinations, the values
of PI increased in all the blood vessels to greater than 1. Intraovarian
blood vessels were detected in 1.8% of the normal ovaries observed in the
postmenopausal women, but PI was always greater than 1. Eleven women with
complex ovarian cysts (not simple) and one woman with enlarged ovaries
underwent explorative laparotomy. In three women, primary malignant ovarian
tumors were diagnosed and in one woman metastatic ovarian cancer was
diagnosed. The specificity of sonography in detecting malignant ovarian
tumors was 97.5% and the positive predictive value was 25%. The specificity
of color flow imaging in detecting primary malignant ovarian tumors was
99.8% and the positive predictive value was 60%. In selected groups of
women, screening for ovarian cancer with transvaginal color flow imaging
may be justified.
