Subjective assessment of adnexal masses with the use of ultrasonography: an analysis of interobserver variability and experience

Abstract

Experienced ultrasonographers using some clinical information and their subjective assessment of ultrasonographic images can differentiate malignant from benign masses in most cases. The accuracy and the level of interobserver agreement are both correlated with experience. About 10% of masses were extremely difficult to classify (only < 50% of assessors were correct).

Comparison of ‘pattern recognition’ and logistic regression models for discrimination between benign and malignant pelvic masses: a prospective cross validation

“…In most cases, an experienced sonographer can confidently and correctly distinguish between benign and malignant adnexal masses on the basis of subjective evaluation of the gray-scale ultrasound image with or without the added information of results of color Doppler ultrasound examination ('pattern recognition'). The figures reported for the sensitivity of pattern recognition range from 88% to 98%, and those for specificity from 89% to 96% [1][2][3] . However, for less experienced sonographers, ultrasound methods other than pattern recognition might be preferable.…”

Confidence of expert ultrasound operators in making a diagnosis of adnexal tumor: effect on diagnostic accuracy and interobserver agreement

“…The ultrasound pattern-recognition technique enables accurate differentiation between benign and malignant adnexal tumors when used by expert ultrasound operators 6,7 . However, we do not know how much the level of confidence in making a diagnosis of adnexal tumor varies between operators and whether the diagnostic accuracy depends on the level of confidence.…”

Which extrauterine pelvic masses are difficult to correctly classify as benign or malignant on the basis of ultrasound findings and is there a way of making a correct diagnosis?

“…Using subjective evaluation of gray-scale and Doppler ultrasound findings, an experienced ultrasound examiner using a good ultrasound system can correctly classify extrauterine pelvic masses as benign or malignant in most cases 1,2 , and suggest a correct specific diagnosis (e.g. endometrioma, dermoid cyst or hydrosalpinx) in many cases 3 .…”