22nd World Congress on Ultrasound in Obstetrics and Gynecology Short oral presentation abstracts OP24.07 Imaging of gynecological disease: clinical and ultrasound characteristics of decidualized endometriomas A. Testa 1 , L. Savelli 2 , I. E. Timor-Tritsch 3 , A. Ercoli 4 , C. Exacoustos 5 , E. Epstein 6 , B. R. Benacerraf 7 , M. Mailath-Pokorny 8 , C. Moruzzi 1 , I. De Blasis 1 , M. Ludovisi 1 , F. Fabbri 9 , D. Timmerman 10 , L. Valentin 11 1 Catholic University of the Sacred Heart, Rome, Italy; 2 Department of Obstetrics and Gynecology, University of Bologna, Bologna, Italy; 3 New York University School and Medical Center, New York City, NY, USA; 4 Department of Gynecology, Policlinico Abano Terme, Abano Terme (PD), Italy; 5 Department of Obstetrics and Gynecology, Universit ` a degli Studi di Roma Torvergata, Rome, Italy; 6 Department of Obstetrics and Gynecology, Karolinska University Hospital, Stockholm, Sweden; 7 Obstetrics Gynecology & Repro. Bio, Harvard Medical School, Boston, MA, USA; 8 Department of Obstetrics and Gynecology, Division of Obstetrics and Fetomaternal Medicine, Vienna, Austria; 9 Dep Obstetrics and Gynecology, University of Bologna, Bologna, Italy; 10 Dep Obstetrics and Gynecology, University Hospital KU Leuven, Leuven, Belgium; 11 Dep Obstetrics and Gynecology, Skane University Hospital, Malmo, Sweden Objectives: To describe the clinical history and ultrasound findings in women with decidualized endometriomas. Methods: Women with a histological diagnosis of decidualized endometrioma during pregnancy who had undergone preoperative ultrasound examination were identified from the databases of 7 ultrasound centers. The tumors were characterized on the basis of ultrasound images, ultrasound reports and research protocols (when applicable) using the terms and definitions of the International Ovarian Tumor Analysis (IOTA) group. Results: Of 18 patients identified, 17 were primigravid and 1 was multiparous. Median age was 33 years (range 20–43). Median ges- tational age at surgical removal of the decidualized endometrioma was 18 weeks, range 11–40. Seventeen patients (94%) were asymp- tomatic, one presented with pelvic pain. In 3 of the 18 patients a diagnosis of endometrioma had been made before pregnancy. The ultrasound examiner was uncertain in 10 (56%) cases and suggested a diagnosis of benignity in 11/18 (61%) cases, borderline in 3 (17%), invasive in 4 (22%) cases. Most decidualized endometriomas (16/18 cases, 89%) contained solid components, vascularized at power Doppler examination. Using pattern recognition most decidualized endometriomas (15/18, 83%) showed the presence of ‘‘rounded’’ papillary projections with a smooth contour. No patient had ascites. Conclusions: Rounded vascularized papillary projections with smooth contour within an ovarian cyst with ground glass echogenic- ity seems to be the landmark of decidualized endometrioma in pregnant patients. OP24.08 Three-dimensional power Doppler angiography as a diagnostic tool in endometrial cancer S. Leisby Antonsen 1 , C. Høgdall 1 , L. N. Jensen 2 , I. Qvist 3 , L. Sperling 4 , A. Tabor 2 1 Department of Gynecology and Obstetrics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; 2 Department of Fetal Medicine and Ultrasound, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; 3 Department of Gynecology and Obstetrics, Aalborg University Hospital, Aalborg, Denmark; 4 Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark Objectives: To assess the usefulness of three-dimensional ultra- sonography (3D) and power Doppler angiography (PDA) in the preoperative evaluation and staging of endometrial cancer (EC). Primary focus was on myometrial and cervical invasion. Methods: 62 consecutive patients from two tertiary centers with histologically verified EC or atypical endometrial hyperplasia were assessed by transvaginal ultrasound scan between April and December 2011. Endometrial thickness (ET), endometrial volume (EV) and 3D-PDA vascular indices (vascularization index (VI), flow index (FI) and vascularization flow index (VFI)) were assessed by three ultrasound experts using the Virtual Organ Computer-aided Analysis method, without knowledge of the pathology results. All patients were surgically staged. Results: 22 (34.9%) women had > 50% myometrial invasion and 13 (20.6%) had cervical involvement. VI and VFI were significantly lower in patients with < 50% myometrial invasion compared with > 50% invasion (P = 0.015 and P = 0.049, resp). VI and FI were significantly lower in low risk patients (endometrioid histology, stage Ia, grade 1–2) compared with all other patients (P = 0.023 and P = 0.018, resp). We found no correlation with histological type and grade, cervical involvement, or lymph node metastases. EV and ET were statistically correlated to myometrial invasion (P < 0.0001), cervical invasion (P = 0.004 and P = 0.001), grade (P = 0.025 and P = 0.032) and low risk patients (P = 0.001 and P = 0.002), but not to histological type or lymph node metastases. Multivariate logistic regression analysis showed that only EV was independently associated with myometrial invasion (P = 0.01) and EV and ET were associated with cervical involvement (P = 0.02 and P = 0.03, resp). Conclusions: 3D-PDA analysis of tumor vascularization in endome- trial cancer patients seems to be promising in the search for better preoperative staging tools. We did not, however, find the 3D-PDA analysis superior to EV or ET with regard to assessing myometrial or cervical invasion. OP24.09 Role of transvaginal color Doppler ultrasound in early diagnosis of ovarian cancer: our experience since 1999 M. Pascual 1 , B. Graupera 1 , L. Hereter 1 , F. Tresserra 2 , M. Cusido 1 , I. Rodr´ ıguez 1 1 Obstetrics, Gynecology and Reproduction, Institut Universitari Dexeus, Barcelona, Spain; 2 Pathology, Institut Universitari Dexeus, Barcelona, Spain Objectives: Ovarian cancer mortality remains high mainly due to late diagnosis. Since 1999 we have performed color Doppler transvaginal (CDTV) ultrasound as a form of screening for ovarian cancer. The purpose of this paper is to assess the efficiency of CDTV ultrasound to detect early stages of ovarian cancer. Methods: Screening CDTV ultrasound has been annually performed in asymptomatic women without a family history of ovarian cancer. Women with abnormal screens had repeat tests after 4–6 weeks. If the finding remitted, CDTV follow-up at one year was performed. If the abnormality persisted, the study was completed with tumor markers, CT scan and laparoscopy. Results: A total of 213.542 screen CDTV ultrasound were performed in 77.048 women. In 51 patients a malignant tumor was diagnosed and histologically confirmed. In twenty-two of them (44.8%), a borderline lesion was detected. The mean age of the patients was 48 years (±12). Thirty-eight (74.5%) of these tumors were in stage I (including two cases of Fallopian tube carcinoma), 3 in stage II, 8 in stage III and two lesions detected were metastasis. A 68.7% of patients had normal levels of CA 125, measured after the detection of the lesions by CDTV study. Conclusions: Although consensus about the benefits of transvaginal ultrasound as a screening procedure is not unanimous, our data suggest that tumors detected in patients screened with transvaginal ultrasound are detected at earlier stages. Additional randomized studies are needed to support these preliminary findings. 128 Ultrasound in Obstetrics & Gynecology 2012; 40 (Suppl. 1): 55–170