3D Power Doppler Ultrasound for Accurate Adnexal Mass Diagnosis

A recent meta-analysis evaluated the effectiveness of three-dimensional power Doppler (3DPD) ultrasound in distinguishing between benign and malignant adnexal masses. By analyzing studies from Medline (PubMed), Scopus, and Web of Science conducted between January 1990 and May 2023, researchers examined 18 studies with a total of 2,975 women. The studies showed a mean malignancy rate of 37% among adnexal masses, with moderate study quality. For all types of adnexal masses, pooled sensitivity and specificity of 3DPD in assessing the vascular structure were 77% and 80%, respectively. The positive likelihood ratio was 3.9, and the negative likelihood ratio was 0.29, though the studies displayed high heterogeneity. For “complex” or “suspicious” adnexal masses, the diagnostic accuracy was notably higher, with sensitivity and specificity reaching 90% and 88%, respectively, and moderate heterogeneity. Although 3DPD proved valuable in assessing the tumor vascular tree for differential diagnosis, researchers found that it does not add significant diagnostic value beyond what current 2D ultrasound techniques offer. This analysis suggests 3DPD could play a role in specific cases of complex adnexal masses, but further studies are necessary to identify optimal use cases and refine criteria for its application. Thus, while 3DPD demonstrates strong diagnostic performance, particularly for complex masses, more research is needed to establish its practical advantages and integration into routine diagnostics.
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