Accuracy of Ultrasonography and Color Doppler in the Diagnosis of Ovarian Masses and Their Correlation with Histopathological Findings

Authors

  • Sumera Nighat Bakhtawar Amin Medical and Dental College, Multan.
  • Ammara Tariq Buch International Hospital, Multan.
  • Nasra Iqbal Bakhtawar Amin Medical and Dental College, Multan.
  • Jaweria Nadeem Buch International Hospital, Multan.
  • Humaira Imran Bakhtawar Amin Medical and Dental College, Multan.
  • Sobia Ishaque Bakhtawar Amin Medical and Dental College, Multan.

DOI:

https://doi.org/10.36283/ziun-pjmd14-4/078

Keywords:

Ovarian mass, Doppler ultrasound, Transvaginal ultrasound, transabdominal ultrasound, Histopathology

Abstract

Background: Ovarian masses are very common gynecological concern in women so, this study is comparing the ultrasonographic and color Doppler findings of ovarian masses with their histopathological diagnosis.

Methods: This prospective study evaluated patients diagnosed with an ovarian mass who visited the obstetrics and gynecology and radiology department of Bakhtawar Amin Medical and Dental College, Multan, between March 2024 and February 2025. The eligible patients were divided into two groups: Group A included patients who underwent abdominal and vaginal ultrasound to assess the morphology of the pelvic mass. In contrast, Group B included patients whose ovarian masses were evaluated using color Doppler in addition to transabdominal ultrasound to examine vascularization as well as morphology. 

Results: Morphology scoring of transabdominal and transvaginal ultrasound showed high accuracy of 98.4%, specificity 96.8%, and NPV 98.0%, while Doppler had lower sensitivity (54.3%) but reasonable specificity (94.2%). The combined approach achieved perfect sensitivity and NPV (100%) with high accuracy (98.4%), enhancing diagnostic performance without losing specificity.

Conclusion: Combining color Doppler with morphological ultrasound improves the accuracy of diagnosing pelvic tumors, enhancing malignancy detection and boosting confidence in benign diagnoses, making it a valuable tool for early disease diagnosis.

Author Biographies

  • Ammara Tariq, Buch International Hospital, Multan.

    Department of Radiology 

  • Nasra Iqbal, Bakhtawar Amin Medical and Dental College, Multan.

    Department of Diagnostic Radiology 

  • Jaweria Nadeem, Buch International Hospital, Multan.

    Department of Radiology 

  • Humaira Imran, Bakhtawar Amin Medical and Dental College, Multan.

    Department of Gynaecology and Obstetrics 

  • Sobia Ishaque , Bakhtawar Amin Medical and Dental College, Multan.

    Department of Obstetrics and Gynecology 

References

References:

1. Firdous A, Saqib HA, Zia ul Islam SN, Ali H, Tahir R, Khan M. Role of doppler ultrasound in detection of malignant lesions in patients presenting with ovarian masses taking histopathology as gold standard. Pak J Med Health Sci. 2021;15(3):654-5. Link. https://pjmhsonline.com/2021/march/654.pdf

2. Birbas E, Kanavos T, Gkrozou F, Skentou C, Daniilidis A, Vatopoulou A. Ovarian masses in children and adolescents: a review of the literature with emphasis on the diagnostic approach. Children. 2023 Jun 27;10(7):1114. doi: 10.3390/children10071114.

3. Nahar K, Begum SK, Jalali MH, Sharmin F, Akhter L, Khanam S. Comparison of Diagnostic Accuracy between CT scan and Colour Doppler USG in Detecting Malignant Ovarian Tumour. Sch Int J Obstet Gynec. 2024;7(12):592-8. DOI: https://doi.org/10.36348/sijog.2024.v07i12.001.

4. Mahale N, Kumar N, Mahale A, Ullal S, Fernandes M, Prabhu S. Validity of ultrasound with color Doppler to differentiate between benign and malignant ovarian tumours. Obstetr Gynecol Sci. 2024;67(2):227-34. doi: 10.5468/ogs.23072.

5. Neelam S, Hayat Z, Jawairiah JS, Sarwat A. Efficacy of Doppler Ultrasound in Detection of Ovarian Malignancy. Pak J Med Health Sci. 2022;16(08):878-. DOI: https://doi.org/10.53350/pjmhs22168878.

6. Kishan TV, Kumar GP, Reddy TV. Role of ultrasonography and magnetic resonance imaging in evaluation of female pelvic masses from reproductive organs with histopathological correlation. Int J Radiol Imaging. 2021;4:30-7. DOI: http://dx.doi.org/10.33545/26644436.2021.v4.i2a.196.

7. Ahmed HE. The usefulness of the ultrasound diagnosis of suspicious ovarian masses based on the O-RADS classification system. Al-Azhar Intern Med J. 2021 Oct 1;2(10):1-6. doi: 10.21608/aimj.2021.90943.1551.

8. Lee SJ, Kim YH, Lee MY, Ko HS, Oh SY, Seol HJ, et al. Ultrasonographic evaluation of ovarian mass for predicting malignancy in pregnant women. Gynecol Oncol. 2021;163(2):385-91. doi: 10.1016/j.ygyno.2021.09.007.

9. Tariq M, Anwar J, Amin N, Gul B, Niaz A, Nawaz KH. Diagnostic accuracy of ultrasound and MRI for diagnosis of adenomyosis taking histopathology as gold standard. Pak Armed Forces Med J. 2022 May 31;72:S346. DOI: http://dx.doi.org/10.33545/26644436.2021.v4.i2a.196.

10. Abbas S, Nisar S, Naseem K, Samad M. Diagnostic accuracy of MRI in diagnosing malignant adnexal masses, taking histopathology as the gold standard. Indus J Biosci Res. 2025;3(4):43-7. DOI:https://doi.org/10.70749/ijbr.v3i4.963.

11. Iqbal I. Farooq MA, Arooj S, Qavi Y, Nasim R, Zafar S. MRI accuracy in diagnosing sonographically indeterminate masses taking histopathology as standard. Proceedings. 2024;38(2):79-84. DOI: https://doi.org/10.47489/szmc.v38i2.480.

12. Pelayo M, Pelayo-Delgado I, Sancho-Sauco J, Sanchez-Zurdo J, Abarca-Martinez L, Corraliza-Galán V, et al. Comparison of ultrasound scores in differentiating between benign and malignant adnexal masses. Diagnostics. 2023;13(7):1307.d oi: 10.3390/diagnostics13071307.

13. Satora M, Kułak K, Zaremba B, Grunwald A, Świechowska-Starek P, Tarkowski R. New hopes and promises in the treatment of ovarian cancer focusing on targeted treatment—a narrative review. Frontiers Pharmacol. 2024 Jun 14;15:1416555. doi: 10.3389/fphar.2024.1416555.

14. Huang J, Chan WC, Ngai CH, Lok V, Zhang L, Lucero-Prisno III DE, et al. Worldwide burden, risk factors, and temporal trends of ovarian cancer: a global study. Cancers. 2022 Apr 29;14(9):2230. doi: 10.3390/cancers14092230.

15. Webb PM, Jordan SJ. Global epidemiology of epithelial ovarian cancer. Nature Reviews Clinical Oncology. 2024 May;21(5):389-400. doi: 10.1038/s41571-024-00881-3.

16. Günkaya OS, Tekin A, Tekelioğlu M, Özköse ZG, Bestel A, Kalkan Ü et al. Role of transvaginal ultrasonography in determining endometrium cancer risk in asymptomatic postmenopausal women with thickened endometrium. J Experiment Clin Med. 2023;40(1):42-6. doi: 10.52142/omujecm.40.1.9.

17. Cong L, Wang S, Yeung SY, Lee JH, Chung JP, Chan DY. Mature cystic teratoma: an integrated review. Int J Molecul Sci. 2023 Mar 24;24(7):6141. doi: 10.3390/ijms24076141.

18. Andreotti RF, Timmerman D, Strachowski LM, Froyman W, Benacerraf BR, Bennett GL, et al. O-RADS US risk stratification and management system: a consensus guideline from the ACR ovarian-adnexal reporting and data system committee. Radiol. 2020;294(1):168-185. doi: 10.1148/radiol.2019191150.

19. Arezzo F, Loizzi V, La Forgia D, Abdulwakil Kawosha A, Silvestris E, Cataldo V, et al. The role of ultrasound guided sampling procedures in the diagnosis of pelvic masses: a narrative review of the literature. Diagnostics. 2021 Nov 26;11(12):2204. doi: 10.3390/diagnostics11122204.

20. Christiansen F, Epstein EL, Smedberg E, Åkerlund M, Smith K, Epstein E. Ultrasound image analysis using deep neural networks for discriminating between benign and malignant ovarian tumors: comparison with expert subjective assessment. Ultrasound Obstet Gynecol. 2021 Jan;57(1):155-63. doi: 10.1002/uog.23530.

21. Wu M, Cui G, Lv S, Chen L, Tian Z, Yang M, Bai W. Deep convolutional neural networks for multiple histologic types of ovarian tumors classification in ultrasound images. Front Oncol. 2023 Jun 23;13:1154200. doi: 10.3389/fonc.2023.1154200.

22. Xun L, Zhai L, Xu H. Comparison of conventional, doppler and contrast-enhanced ultrasonography in differential diagnosis of ovarian masses: a systematic review and meta-analysis. BMJ Open. 2021 Dec 1;11(12):e052830. doi: 10.1136/bmjopen-2021-052830.

23. Tongsong T, Wanapirak C, Neeyalavira V, Khunamornpong S, Sukpan K. E-flow doppler indices for prediction of benign and malignant ovarian tumors. Asian Pac J Cancer Prev. 2009;10:139-42. Link. https://w1.med.cmu.ac.th/obgyn/files/2022/01/342-Tongsong-2009-3.pdf

24. Sassone AM, Timor-Tritsch IE, Artner A, Westhoff C, Warren WB. Transvaginal sonographic characterization of ovarian disease: evaluation of a new scoring system to predict ovarian malignancy. Obstet Gynecol. 1991;78:70-6. PMID: 2047071.

25. Ghazal K, El Hasan J, Hijasi H, Koulaima E. Accuracy of ultrasonography and color Doppler in diagnosis of ovarian masses and its correlation with histopathological findings. Int J Reprod Contracept Obstet Gynecol. 2020;9:4812-9. link.gale.com/apps/doc/A646153486/AONE?u=anon~f7536b4c&sid=googleScholar&xid=8a87918b

Downloads

Published

2025-09-29

Metrics

How to Cite

1.
Nighat S, Tariq A, Iqbal N, Nadeem J, Imran H, Ishaque S. Accuracy of Ultrasonography and Color Doppler in the Diagnosis of Ovarian Masses and Their Correlation with Histopathological Findings. PJMD [Internet]. 2025 Sep. 29 [cited 2026 Jun. 14];14(4). Available from: https://ojs.zu.edu.pk/pjmd/article/view/4134

Similar Articles

111-119 of 119

You may also start an advanced similarity search for this article.