Journal of Ultrasound in Medicine, Vol 13, Issue 1 37-41, Copyright © 1994 by American Institute of Ultrasound in Medicine
Transvaginal sonography, color flow imaging, computed tomographic scanning, and CA 125 as a routine follow-up examination in women with pelvic tumor: detection of recurrent disease
Z. Weiner, D. Beck and J. M. Brandes
Department of Obstetrics and Gynecology, Rambam Medical Center, Technion-Israel Institute of Technology, Haifa.
We were trying to determine whether transvaginal sonography combined with
color flow imaging should be used routinely for detecting recurrent pelvic
tumors in patients treated for pelvic cancer. Eighteen patients who had
completed their treatment for pelvic tumor were examined every 6 months by
gynecologic examination, a CT scan, serum CA 125 levels, and transvaginal
sonography with color flow imaging. Laparotomy or fine-needle biopsy was
performed when a recurrent pelvic mass was observed or suspected on CT
scans or transvaginal sonography. In nine of 18 patients a recurrent pelvic
tumor was observed or suspected on CT scans or on transvaginal sonography.
A recurrent pelvic tumor was diagnosed on laparotomy in five patients. In
four patients, only a fine-needle biopsy was performed and only two of them
had positive results. The highest sensitivity and specificity for detecting
recurrent pelvic tumors were achieved by transvaginal sonography (100 and
91%, respectively) and by color flow imaging (86 and 100%, respectively).
Intratumoral blood vessels were detected in all cases with recurrent pelvic
tumors, and in only one of these cases the PI was high. We recommend a
routine follow-up with transvaginal sonography in women completing their
treatment for pelvic tumors. When a recurrence of tumor is only suspected
on transvaginal sonography, color flow imaging may be used as an additional
diagnostic tool.
