A comparison of colour Doppler sonography and the pelvic arteriogram in assessment of patients with gestational trophoblastic disease

Abstract

Objective - To assess whether colour Doppler sonography can replace pelvic arteriography in the assessment of patients with gestational trophoblastic disease. Design - An observational study in which patients with gestational trophoblastic disease were assessed with both pelvic arteriography and colour Doppler sonography. Setting The oncology unit of the Department of Obstetrics and Gynaecology, University of] long Kong. The unit is the main tertiary referral centre for treatment of trophoblastic diseases in Hong Kong. Subjects - Thirty-two consecutive women referred over an 18 month period. Main outcome measures The site of localisation of the tumour and the size of the tumour as assessed by both methods. Results - Eleven patients had a spontaneous fall of β-hCG titres and did not have pelvic arteriograms performed. The remaining 21 patients had both investigations performed. Four patients had no evidence of abnormal pelvic vessels either on colour Doppler sonography or on pelvic arteriography. Their raised β hCG titres were due to metastatic disease elsewhere. In the remaining patients the location of the tumour vessels was found to be concordant between the two methods of imaging. Measurements of the mean diameter of tumour bulk by the two methods also agreed well (r = 0.93, P < 0.0001). Pelvic arteriogram over-estimated the size of the tumour in two patients by 2 and 3 cm, respectively, but this did not alter the risk categories of the patients. Conclusion - Colour Doppler sonography is a noninvasive technique that can replace pelvic arteriography in the assessment of patients with trophoblastic diseases.