A comparison of color flow Doppler and serum CA 125 measurement in the preoperative evaluation of a complex pelvic mass

Ferrier AJ, Picker RH, Sinosich M. A comparison of color flow Doppler and serum CA 125 measurement in the preoperative evaluation of a complex pelvic mass. Int J Gynecol Cancer 1998; 8:113–118. Preoperative diagnosis of a malignant pelvic mass is frequently missed, resulting in suboptimal surgical management. This study evaluated the diagnostic properties of color flow Doppler and a single preoperative serum CA 125 measurement in discriminating malignant from benign pelvic tumors. Sixty-two patients were assessed, 32 with an histologically proven ovarian malignancy. Using an upper cutpoint of 0.40 for the resistance index (RI), the likelihood ratio (LR) for the diagnosis of a malignant tumor was 1.72 (95% CI 0.73–4.07). The associated probability of a malignant pelvic mass was 0.63 (95% CI 0.42–0.80). The LRs for CA 125 at the lower cutpoints of 35 U/ml and 65 U/ml were 3.62 (95% CI 1.86–7.04) and 4.50 (95% CI 1.97–10.27), respectively. The corresponding probability estimates were 0.78 (95% CI 0.065–0. 88) and 0.82 (95% CI 0.66–0.91), respectively. Combining the RI (cutpoint 0.40) and CA 125 (cutpoint 35 U/ml) resulted in a LR of 5 (95% CI 1.62–15.4) and a probability estimate of 0.83. This is only a marginal increase over CA 125 measurement alone. This study does not support the use of color flow Doppler in the diagnostic assessment of a suspicious pelvic mass.