Power Doppler Quantification in Assessing Gestational Trophoblastic Neoplasia.

Abstract

PURPOSE:

 The FIGO score cannot accurately stratify low-risk gestational trophoblastic neoplasia (GTN) patients who develop chemoresistance to single agent methotrexate chemotherapy. Tumour vascularisation is a key risk factor and its quantification may provide non-invasive way of complementing risk assessment.

MATERIALS AND METHODS:

 187 FIGO-staged, low-risk GTN patients were prospectively recruited. Power Doppler ultrasound was analysed using a quantification program. Four diagnostic indicators were obtained comprising the number of colour pixels (NCP), mean dB, power Doppler quantification (PDQ), and percentage of colour pixels (%CP). Each indicator performance was assessed to determine if they could distinguish the subset of low-risk patients who became chemoresistant.

RESULTS:

 There were 111 non-resistant and 76 resistant patients. NCP performed best at distinguishing these two groups where the non-resistant group had an average 3435 (± 2060) pixels and the resistant group 6151 (± 3192) pixels (p < 0.001). PDQ and %CP showed significant differences (p < 0.001) but had poorer performance (area under ROC curves were 72 % and 67 % respectively compared with 75 % for NCP). The mean dB index was not significantly different (p = 0.133).

CONCLUSION:

 Power Doppler ultrasound quantification shows potential for non-invasive assessment of tumour vascularity and can distinguish low-risk GTN patients who become chemoresistant from those who have an uncomplicated course with first line treatment.

• Authors: Yuanwei Li, Meng Xing Tang, Roshan Agarwal, Daksha Patel, Robert J Eckersley, Guillaume Barrois, Mary E Roddie, Linda Dayal, Philip M Savage, Michael J Seckl, Adrian Lim
• Journal: Ultraschall in der Medizin (Stuttgart, Germany : 1980) (Ultraschall Med) Vol. 39 Issue 2 Pg. 206-212 (Apr 2018) ISSN: 1438-8782 [Electronic] Germany
• Vernacular Title: Powerdoppler-Quantifizierung zur Beurteilung der gestationsbedingten trophoblastischen Neoplasie.
• PMID: 27529457 (Publication Type: Journal Article)
• Copyright: © Georg Thieme Verlag KG Stuttgart · New York.

Chemical References

• Methotrexate

Topics

• Adult
• Antineoplastic Combined Chemotherapy Protocols
• Drug Resistance, Neoplasm
• Female
• Gestational Trophoblastic Disease
• Humans
• Methotrexate
• Middle Aged
• Pregnancy
• Risk Factors
• Ultrasonography, Doppler