Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 0 0 2026 04 21 11921 11921 Rana Matrood Alkhazraji Department of Obstetrics and Gynecology, College of Medicine, University of Al-Qadisiyah, Al-Qadisiyah, Iraq. 2025 12 03 2025 12 23 Some studies have concluded that PI and RI play an inadequate role in distinguishing benign tumors from malignant ones; however, later studies have reported different results, showing that Doppler ultrasound is effective in differentiating malignant from non‑malignant ovarian masses by using specific threshold values for both RI and PI. The presence of such conflicting data justifies our study. The purpose of this project was to use color Doppler and ultrasound imaging to differentiate between malignant and benign ovarian tumors and to verify the findings by comparing them with histopathology. Over the course of two years, 86 patients with ovarian masses were evaluated for morphologic features, pulsatility indices (PI), and resistance indices (RI) using Doppler ultrasound. Histopathologic confirmation served as the basis for the final diagnosis. The cutoff value for RI was ≤0.39 and for PI was ≤1.1, as shown in figures 1 and 2 and table 1. The sensitivity, specificity, and positive and negative predictive values were all 100%. Doppler ultrasound provides effective tools, including resistive and pulsatility indices, that can be used to differentiate between benign and malignant ovarian masses.     https://acta.tums.ac.ir/index.php/acta/article/view/11921 https://acta.tums.ac.ir/index.php/acta/article/download/11921/6029