Transvaginal (endovaginal) ultrasound screening provides high-resolution images of the uterus and ovaries. This allows the entire uterus to be observed for cancer of the endometrium. Ovarian cancer can be detected before the lesions are palpable. The procedure involves the insertion of a small probe into the vagina. The probe then sends out ultrasound waves that are used to generate an image of the tissues.(1) Signs of possible cancer that can be detected this way include: masses and altered (low-velocity) blood flow.(2)
Three-dimensional (as opposed to two-dimensional) Doppler imaging has been shown in trials to significantly improve the specificity of the screening. This technique allowed benign masses to be distinguished from malignant ones with more accuracy.(2)
Currently, transvaginal ultrasound screening does not have high enough specificity and sensitivity to significantly decrease mortality in the general population. The costs are high and ovarian cancer is not very prevalent. However, the screening is recommended for women at high risk of developing ovarian cancer, such as those with a family history of breast and ovarian cancer and/or those who carry a BRCA-1 or -2 mutation.(3)
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