Diagnostic Accuracy of Gray-Scale Ultrasonography and Color Doppler Ultrasonography in Differentiating Benign from Malignant Ovarian Masses

Open Access

Abstract

Background: Ovarian cancer is one of the deadliest gynecological cancers in the world, and late diagnosis of the disease is a major factor in poor survival rates. The correct and timely diagnosis of benign and malignant ovarian masses is crucial to direct clinical management. This study aimed to assess the diagnostic value of gray-scale ultrasonography and color Doppler ultrasonography in differentiating benign from malignant ovarian masses. Methods & Materials: This cross-sectional study was conducted in the Department of Radiology and Imaging, Jalalabad Ragib-Rabeya Medical College, Sylhet, Bangladesh, from January 2025 to December 2025. 32 patients with sonographically identified ovarian masses were recruited according to the inclusion and exclusion criteria. All patients were evaluated by gray-scale and color Doppler ultrasonography and then the resected tissue was examined histopathologically. Sonographic parameters such as mass morphology, vascularity, resistance index (RI), and pulsatility index (PI) were documented and correlated with the histopathology. Data were entered and analyzed on SPSS version 26. Results: The benign and malignant ovarian masses on histopathology were found in 19 (59.4%) and 13 (40.6%) of the 32 participants, respectively. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of gray-scale ultrasonography were 76.9%, 78.9%, 71.4%, 83.3%, and 78.1%, respectively. The sensitivity, specificity, PPV, NPV, and accuracy of color Doppler ultrasonography were 92.3%, 89.5%, 85.7%, 94.4%, and 90.6%, respectively. Malignant masses were more likely to be bilateral, show high central vascularity, and low RI (<0.50) and PI (<1.00). Conclusion: Color Doppler ultrasonography is much more accurate than gray-scale ultrasonography alone in distinguishing between benign and malignant ovarian masses. Both modalities are useful in the preoperative evaluation of ovarian masses, and their combination is reliable, non-invasive, and cost-effective.