TRANSVAGINAL SONOGRAPHY IN THE DIAGNOSIS OF PELVIC MALIGNANT RECURRENCE - INTEGRATION OF SONOGRAPHY AND NEEDLE-GUIDED BIOPSY

The aim of this study was to evaluate the efficiency of transvaginal s onography and sonography plus needle biopsy in detecting pelvic malign ant recurrence. We scanned 24 patients already treated for gynecologic al malignancy, 21 of whom underwent needle biopsy under sonographic gu idance. Thirteen patients were affected by cervical cancer, ten by ova rian cancer, and one by endometrial-ovarian carcinoma. Sonography dete cted 16 solid or cystic-solid masses (median size 52 mm, range 15-85 m m), one case of ascites, and one liquid mass (hematoma). All the patie nts in whom a suspicious mass was detected had recurrence. In the six patients in whom no mass was visible, two had recurrence. Needle biops y was able to demonstrate recurrence in 17 patients (also in two false -negative scans). In one, even though sonography detected a mass, the histological sample was negative, but recurrence was later diagnosed b y laparotomy. Accuracy, sensitivity and specificity of transvaginal so nography were respectively 91.6%, 89.4% and 100%. The positive predict ive value was 100% and the negative predictive value was 71.4%. Transv aginal sonography was shown to be a useful means of detecting pelvic r ecurrence.