A COMPARISON OF COLOR DOPPLER SONOGRAPBY AND THE PELVIC ARTERIOGRAM IN ASSESSMENT OF PATIENTS WITH GESTATIONAL TROPHOBLASTIC DISEASE

Objective To assess whether colour Doppler sonography can replace pelv ic arteriography in the assessment of patients with gestational tropho blastic disease.Design An observational study in which patients with g estational trophoblastic disease were assessed with both pelvic arteri ography and colour Doppler sonography. Setting The oncology unit of th e Department of Obstetrics and Gynaecology, University of Hong Kong. T he unit is the main tertiary referral centre for treatment of trophobl astic diseases in Hong Kong. Subjects Thirty-two consecutive women ref erred over an 18 month period, Main outcome measures The site of local isation of the tumour and the size of the tumour as assessed by both m ethods. Results Eleven patients had a spontaneous fall of beta-hCG tit res and did not have pelvic arteriograms performed. The remaining 21 p atients had both investigations performed. Four patients had no eviden ce of abnormal pelvic vessels either on colour Doppler sonography or o n pelvic arteriography. Their raised beta hCG titres were due to metas tatic disease elsewhere. In the remaining patients the location of the tumour vessels was found to be concordant between the two methods of imaging. Measurements of the mean diameter of tumour bulk by the two m ethods also agreed well (r = 0.93, P < 0.0001). Pelvic arteriogram ove r-estimated the size of the tumour in two patients by 2 and 3 cm, resp ectively, but this did not alter the risk categories of the patients. Conclusion Colour Doppler sonography is a noninvasive technique that c an replace pelvic arteriography in the assessment of patients with tro phoblastic diseases.