Evidence map›Paper›PMID 40387112›Full record

ArticleUltrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology2025

Additional value of uterine artery Doppler pulsatility index for ultrasound diagnosis of placental site trophoblastic tumor: prospective cohort study.

R Cioffi, P I Cavoretto, G Sabetta, A Bergamini, E Rabaiotti, M Candiani, G Mangili

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Article in Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

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6citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

R CioffiDepartment of Obstetrics and Gynecology, IRCCS San Raffaele Hospital, Milan, Italy.ORCID 0000-0003-4370-8271
P I CavorettoDepartment of Obstetrics and Gynecology, IRCCS San Raffaele Hospital, Milan, Italy.ORCID 0000-0001-8097-366X
G SabettaDepartment of Obstetrics and Gynecology, IRCCS San Raffaele Hospital, Milan, Italy.
A BergaminiDepartment of Obstetrics and Gynecology, IRCCS San Raffaele Hospital, Milan, Italy.ORCID 0000-0002-1915-8313
E RabaiottiDepartment of Obstetrics and Gynecology, IRCCS San Raffaele Hospital, Milan, Italy.
M CandianiDepartment of Obstetrics and Gynecology, IRCCS San Raffaele Hospital, Milan, Italy.ORCID 0000-0002-2129-2626
G MangiliDepartment of Obstetrics and Gynecology, IRCCS San Raffaele Hospital, Milan, Italy.ORCID 0000-0002-8451-429X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe ultrasound diagnosis of placental site trophoblastic tumor (PSTT) is challenging owing to a lack of pathognomonic features. Differential diagnosis from other forms of gestational trophoblastic neoplasia (GTN) is critical owing to major differences in prognosis and treatment. Doppler measurement of uterine artery (UtA) pulsatility index (PI) has been proposed for the diagnosis and management of GTN. The aim of this study was to evaluate the added value of UtA-PI Doppler measurement during the standard transvaginal ultrasound (TVS) assessment, in patients with PSTT as compared to those with other GTN.

methodsThis was a single-center prospective cohort study involving ultrasound assessment of all GTN cases referred to and treated at the trophoblast unit of San Raffaele Hospital, Milan, Italy, between 2011 and 2023. TVS assessment included: grayscale analysis for the detection of myometrial or endometrial abnormalities, color and power Doppler assessment of lesions with scoring of vascularization, and spectral pulsed-wave Doppler for measurement of mean UtA-PI from the left and right UtAs. Sonographic findings were compared between patients with PSTT and those with other forms of GTN (postmolar, invasive mole or choriocarcinoma), using non-parametric two-tailed statistical analysis.

resultsA total of 73 GTN cases were recruited, comprising nine (12.3%) with PSTT and 64 (87.7%) with other GTN. A significant difference was detected between other-GTN and PSTT cases when comparing rates of substantial endometrial vascularity on Doppler (50% vs 0%; P = 0.013) and mean UtA-PI measurements (median, 1.5 (interquartile range (IQR), 1.0-2.4) vs 2.2 (IQR, 1.5-2.7); P = 0.014; area under the receiver-operating-characteristics curve, 0.768 (95% CI, 0.610-0.888)).

conclusionsThis study describes UtA-PI as a novel and effective marker allowing for the ultrasound differentiation of PSTT from other forms of GTN. The significantly higher mean UtA-PI and lower endometrial vascularity observed in PSTT as compared with other GTN suggests a unique vascularization pattern, with a potential role in differential diagnosis and management. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Indexed as

Trophoblastic Tumor, Placental SiteUltrasonography, DopplerUltrasonography, PrenatalUterine ArteryUterine NeoplasmsAdultDiagnosis, DifferentialFemaleGestational Trophoblastic DiseaseHumansItalyPregnancyProspective StudiesPulsatile FlowUltrasonography, Doppler, Colorchoriocarcinomacolor‐power Dopplergestational trophoblastic neoplasiaplacental site trophoblastic tumoruterine artery pulsatility index

Identifiers

PMID40387112
PMCPMC12209685

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.