open access

Vol 90, No 11 (2019)
ORIGINAL PAPERS Gynecology
Published online: 2019-11-28
Get Citation

The assessment of spectral Doppler parameters in uterine arteries of patients with locally advanced squamous cell cervical cancer

Adam Tomalczyk, Bartlomiej Tomasik, Malgorzata Moszynska-Zielinska, Jacek Fijuth, Michal Spych, Leszek Gottwald
DOI: 10.5603/GP.2019.0101
·
Pubmed: 31802461
·
Ginekol Pol 2019;90(11):622-627.

open access

Vol 90, No 11 (2019)
ORIGINAL PAPERS Gynecology
Published online: 2019-11-28

Abstract

Objectives: Evaluate spectral Doppler parameters peak systolic velocity (PSV), end diastolic velocity (EDV), resistance index (RI) and pulsatility index (PI) in infiltrated and non-infiltrated uterine arteries of patients with locally advanced (stages II B, III B) squamous cell cervical cancer and their changes during treatment. 

Material and methods: the study group included 36 patients aged 35–78 years old. At diagnosis, PSV, EDV, RI and PI in uterine arteries were examined and compared with MRI findings. All patients underwent transvaginal doppler ultrasonography prior to the treatment, after external beam radiation therapy and six weeks after the last application of brachytherapy. 

Results: The median PSV value in the first examination was higher in infiltrated uterine arteries than compared to non-infiltrated ones (p = 0.001). The PSV values for all vessels decreased between the first and the third observation (p < 0.001). There was a significant difference in PI values between infiltrated and non-infiltrated uterine arteries between the first and the third examination (p = 0.027). 

Conclusions: In patients with locally advanced cervical cancer of uterine arteries, assessment of PSV but not EDV, RI or PI can be helpful in differentiating infiltrated from non-infiltrated vessels. In this group of patients, radiotherapy decreases PSV, but not EDV, RI or PI values in uterine arteries. An observation conducted from the onset of radiotherapy to end of the follow-up in uterine arteries reveals that PI, but not RI, PSV or EDV, is different in infiltrated and non-infiltrated vessels.

Abstract

Objectives: Evaluate spectral Doppler parameters peak systolic velocity (PSV), end diastolic velocity (EDV), resistance index (RI) and pulsatility index (PI) in infiltrated and non-infiltrated uterine arteries of patients with locally advanced (stages II B, III B) squamous cell cervical cancer and their changes during treatment. 

Material and methods: the study group included 36 patients aged 35–78 years old. At diagnosis, PSV, EDV, RI and PI in uterine arteries were examined and compared with MRI findings. All patients underwent transvaginal doppler ultrasonography prior to the treatment, after external beam radiation therapy and six weeks after the last application of brachytherapy. 

Results: The median PSV value in the first examination was higher in infiltrated uterine arteries than compared to non-infiltrated ones (p = 0.001). The PSV values for all vessels decreased between the first and the third observation (p < 0.001). There was a significant difference in PI values between infiltrated and non-infiltrated uterine arteries between the first and the third examination (p = 0.027). 

Conclusions: In patients with locally advanced cervical cancer of uterine arteries, assessment of PSV but not EDV, RI or PI can be helpful in differentiating infiltrated from non-infiltrated vessels. In this group of patients, radiotherapy decreases PSV, but not EDV, RI or PI values in uterine arteries. An observation conducted from the onset of radiotherapy to end of the follow-up in uterine arteries reveals that PI, but not RI, PSV or EDV, is different in infiltrated and non-infiltrated vessels.

Get Citation

Keywords

cervical cancer; locally advanced; spectral Doppler; uterine artery; infiltration

About this article
Title

The assessment of spectral Doppler parameters in uterine arteries of patients with locally advanced squamous cell cervical cancer

Journal

Ginekologia Polska

Issue

Vol 90, No 11 (2019)

Pages

622-627

Published online

2019-11-28

DOI

10.5603/GP.2019.0101

Pubmed

31802461

Bibliographic record

Ginekol Pol 2019;90(11):622-627.

Keywords

cervical cancer
locally advanced
spectral Doppler
uterine artery
infiltration

Authors

Adam Tomalczyk
Bartlomiej Tomasik
Malgorzata Moszynska-Zielinska
Jacek Fijuth
Michal Spych
Leszek Gottwald

References (26)
  1. Bhatla N, Aoki D, Sharma DN, et al. Cancer of the cervix uteri. Int J Gynaecol Obstet. 2018; 143 Suppl 2: 22–36.
  2. Kato T, Watari H, Takeda M, et al. Multivariate prognostic analysis of adenocarcinoma of the uterine cervix treated with radical hysterectomy and systematic lymphadenectomy. J Gynecol Oncol. 2013; 24(3): 222–228.
  3. Testa A, Legge ADi, Blasis IDe, et al. Imaging techniques for the evaluation of cervical cancer. Best Pract Res Clin Obstet Gynaecol. 2014; 28(5): 741–768.
  4. Sammet S. Magnetic resonance safety. Abdom Radiol (NY). 2016; 41(3): 444–451.
  5. Folkman J, Watson K, Ingber D, et al. Induction of angiogenesis during the transition from hyperplasia to neoplasia. Nature. 1989; 339(6219): 58–61.
  6. Gammill SL, Shipkey FH, Himmelfarb EH, et al. Roentgenology-pathology correlative study of neovascularity. AJR Am J Roentgenol. 1976; 126(2): 376–385.
  7. Taylor KJ, Ramos I, Carter D, et al. Correlation of Doppler US tumor signals with neovascular morphologic features. Radiology. 1988; 166(1 Pt 1): 57–62.
  8. Fajardo LF, Berthrong M. Vascular lesions following radiation. Pathol Annu. 1988; 23 Pt 1: 297–330.
  9. Alcázar JL, Castillo G, Martínez-Monge R, et al. Transvaginal color Doppler sonography for predicting response to concurrent chemoradiotherapy for locally advanced cervical carcinoma. J Clin Ultrasound. 2004; 32(6): 267–272.
  10. Alcázar JL, Jurado M. Transvaginal color Doppler for predicting pathological response to preoperative chemoradiation in locally advanced cervical carcinoma: a preliminary study. Ultrasound Med Biol. 1999; 25(7): 1041–1045.
  11. Kerimoğlu U, Akata D, Hazirolan T, et al. Evaluation of radiotherapy response of cervical carcinoma with gray scale and color Doppler ultrasonography: resistive index correlation with magnetic resonance findings. Diagn Interv Radiol. 2006; 12(3): 155–160.
  12. Testa AC, Ferrandina G, Distefano M, et al. Color Doppler velocimetry and three-dimensional color power angiography of cervical carcinoma. Ultrasound Obstet Gynecol. 2004; 24(4): 445–452.
  13. Wu YC, Yuan CC, Hung JH, et al. Power Doppler angiographic appearance and blood flow velocity waveforms in invasive cervical carcinoma. Gynecol Oncol. 2000; 79(2): 181–186.
  14. Pirhonen JP, Grenman SA, Bredbacka AB, et al. Effects of external radiotherapy on uterine blood flow in patients with advanced cervical carcinoma assessed by color Doppler ultrasonography. Cancer. 1995; 76(1): 67–71.
  15. Fischerova D, Cibula D, Stenhova H, et al. Transrectal ultrasound and magnetic resonance imaging in staging of early cervical cancer. Int J Gynecol Cancer. 2008; 18(4): 766–772.
  16. Testa AC, Ludovisi M, Manfredi R, et al. Transvaginal ultrasonography and magnetic resonance imaging for assessment of presence, size and extent of invasive cervical cancer. Ultrasound Obstet Gynecol. 2009; 34(3): 335–344.
  17. Epstein E, Testa A, Gaurilcikas A, et al. Early-stage cervical cancer: tumor delineation by magnetic resonance imaging and ultrasound - a European multicenter trial. Gynecol Oncol. 2013; 128(3): 449–453.
  18. Gaurilcikas A, Vaitkiene D, Cizauskas A, et al. Early-stage cervical cancer: agreement between ultrasound and histopathological findings with regard to tumor size and extent of local disease. Ultrasound Obstet Gynecol. 2011; 38(6): 707–715.
  19. Csutak C, Badea R, Bolboaca SD, et al. Multimodal endocavitary ultrasound versus MRI and clinical findings in pre- and post-treatment advanced cervical cancer. Preliminary report. Med Ultrason. 2016; 18(1): 75–81.
  20. Moloney F, Ryan D, Twomey M, et al. Comparison of MRI and high-resolution transvaginal sonography for the local staging of cervical cancer. J Clin Ultrasound. 2016; 44(2): 78–84.
  21. Chiappa V, Di Legge A, Valentini AL, et al. Agreement of two-dimensional and three-dimensional transvaginal ultrasound with magnetic resonance imaging in assessment of parametrial infiltration in cervical cancer. Ultrasound Obstet Gynecol. 2015; 45(4): 459–469.
  22. Alcázar JL, Castillo G, Jurado M, et al. Intratumoral blood flow in cervical cancer as assessed by transvaginal color doppler ultrasonography: Correlation with tumor characteristics. Int J Gynecol Cancer. 2003; 13(4): 510–514.
  23. Hsu KF, Su JM, Huang SC, et al. Three-dimensional power Doppler imaging of early-stage cervical cancer. Ultrasound Obstet Gynecol. 2004; 24(6): 664–671.
  24. Enzelsberger H, Skodler WD, Vavra N, et al. Ultrasonic Doppler flow studies of the uterine arteries in women with cervix cancer. Gynecol Obstet Invest. 1991; 32(2): 112–114.
  25. Breyer B, Despot A, Predanic M, et al. Characteristics of blood flow in cancer of the uterine cervix. Ultrasound Obstet Gynecol. 1993; 3(4): 268–270.
  26. Bolla D, In-Albon S, Papadia A, et al. Doppler Ultrasound Flow Evaluation of the Uterine Arteries Significantly Correlates with Tumor Size in Cervical Cancer Patients. Ann Surg Oncol. 2015; 22 Suppl 3: S959–S963.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk
tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl