Transvaginal sonography, color flow imaging, computed tomographic scanning, and CA 125 as a routine follow-up examination in women with pelvic tumor: detection of recurrent disease.

We were trying to determine whether transvaginal sonography combined with color flow imaging should be used routinely for detecting recurrent pelvic tumors in patients treated for pelvic cancer. Eighteen patients who had completed their treatment for pelvic tumor were examined every 6 months by gynecologic examination, a CT scan, serum CA 125 levels, and transvaginal sonography with color flow imaging. Laparotomy or fine-needle biopsy was performed when a recurrent pelvic mass was observed or suspected on CT scans or transvaginal sonography. In nine of 18 patients a recurrent pelvic tumor was observed or suspected on CT scans or on transvaginal sonography. A recurrent pelvic tumor was diagnosed on laparotomy in five patients. In four patients, only a fine-needle biopsy was performed and only two of them had positive results. The highest sensitivity and specificity for detecting recurrent pelvic tumors were achieved by transvaginal sonography (100 and 91%, respectively) and by color flow imaging (86 and 100%, respectively). Intratumoral blood vessels were detected in all cases with recurrent pelvic tumors, and in only one of these cases the PI was high. We recommend a routine follow-up with transvaginal sonography in women completing their treatment for pelvic tumors. When a recurrence of tumor is only suspected on transvaginal sonography, color flow imaging may be used as an additional diagnostic tool.