Color Doppler in the assessment of cervical cancer

Abstract

The treatment and prognosis of cervical cancer depends on the clinical stage based on the FIGO classification and the presence of lymph node metastases. Clinical staging of cervical cancer does not attain a good diagnostic performance, since it is incorrect in approximately one‐third of patients who undergo surgical staging. Magnetic resonance (MR) imaging resulted to be superior to clinical evaluation and computed tomography (CT) in parametrial evaluation and in the staging of uterine cervical carcinoma. Endoluminal ultrasound was introduced to analyse the cervix but no improvement in the diagnostic accuracy with respect to clinical staging was obtained. Color Doppler velocimetry was proposed as a non‐invasive tool in the examination of cervical cancer. Cervical cancers with detectable intratumoral blood flow were associated with larger size, invasion of parametrium, pelvic lymph node metastases and greater microvessel density. A ‘vascularity index’ resulted to be correlated with staging and lymph node metastases. The aims of our study were to assess color Doppler characteristics of 48 cervical cancers at different stages and to analyse the correlation between Doppler parameters and clinical–pathological features of the tumors. Three‐dimensional color power Doppler technique was used to investigate the vascular architecture of the neoplastic tissue. Three‐dimensional vascular images were compared to magnetic resonance results. The actual clinical application of the three‐dimensional vascular analysis in the evaluation of cervical cancers remains still to be defined.