3D vocal power Doppler sonography for the estimation of tumor volume and vascularization in stage IB1 cervical cancer.

Purpose: To evaluate the tumor's volume and intratumoral vascularization with 3D vocal power Doppler ultrasound in patients with stage 1B1 cervical cancer.

Methods: This was a prospective study on patients with cervical cancer and stage 1B1 disease, which took place between 2012 and 2015. All women had an initial 2D ultrasound examination for the estimation of the tumor volume. Following this, 3D volumes of the cervix were acquired and were further analyzed using the Virtual Organ Computer Aided Analysis (VOCAL) program. In the selected volume, the vascular pattern (linear or complex vascularization) was also examined. The ultrasonographic findings were compared to the histological ones following surgery.

Results: Twenty-seven patients were included. The average cervical tumor volume measured by the 2D ultrasound and 3D VOCAL-PD were 3.14 and 3.08 cm, respectively. Both 2D and 3D VOCAL-PD overestimated the tumor staging. Further analysis showed a statistically significant superiority of 2D ultrasound over 3D VOCAL-PD for tumors equal or smaller than 2.5 cm with linear vascularity (p < 0.001), while for tumors of larger volume with complex vascularization, a statistically significant superiority of 3D VOCAL-PD was confirmed (p < 0.001).

Conclusions: 3-D VOCAL-PD is extremely accurate and superior to 2D ultrasound for the estimation of tumor volume and vascularization when it is more than 2.5 cm and has a complex vascularization in patients with stage 1B1 cervical cancer.