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  • Title: Controversies in assessment of ovarian tumors with transvaginal color Doppler ultrasound.
    Author: Tekay A, Jouppila P.
    Journal: Acta Obstet Gynecol Scand; 1996 Apr; 75(4):316-29. PubMed ID: 8638449.
    Abstract:
    BACKGROUND: The observations made in the late 1980s indicated that the transvaginal color Doppler ultrasound can be used in the detection of ovarian cancer. This has generated a stream of clinical trials. The conflicting results of numerous publications, however, have led to a major controversy. The aim of this communication is to review the literature and our own observations in order to provide more insight into the subject. RESULTS: The performance characteristics of the 32 previous transvaginal color Doppler ultrasound studies showed a considerable heterogeneity: the sensitivity was 25%-100%, the specificity was 46%-100%, the positive predictive value was 28.6%-100% and the negative predictive value was 63%-100%. The accuracy varied between 57% and 100%. An indisputable overlap was found between the ranges of pulsatility index (PI) and resistance index (RI) values from the benign and malignant adnexal tumors. The RI was <0.40 in 43% of benign tumors and in 25% of the normal vascular ovaries. CONCLUSION: The current cut-off levels for PI or RI values should not be used in clinical decision making due to their poor specificity.
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