title: Three-dimensional sonographic morphologic assessment of adnexal masses: a reproducibility study.
abstract: OBJECTIVE
  The purpose of this study was to assess the reproducibility of 3-dimensional (3D) sonography for classifying adnexal masses.
  
  
  METHODS
  Eighty-two consecutive women with the diagnosis of an adnexal mass on 2-dimensional transvaginal sonography were reevaluated by 3D sonography, and 3D volume data from each mass were stored. Two different examiners (6 years and 1 year of experience in 3D sonography, respectively) reviewed 3D sonograms 1 month after the last patient was recruited and then 1 week later again. Masses had to be classified as benign or malignant. Criteria suggestive of malignancy were the presence of a thick wall, gross papillary projections, solid areas, and solid echogenicity. A definitive histologic diagnosis was obtained in every case. Intraobserver and interobserver agreement was estimated by calculating the Cohen kappa index.
  
  
  RESULTS
  Twenty-seven (33%) tumors were malignant, and 55 (67%) were benign. Intraobserver agreement for both examiners was good (kappa = 0.78 and 0.72, respectively). Interobserver agreement was also good (kappa = 0.70).
  
  
  CONCLUSIONS
  Three-dimensional sonography is a reproducible technique for morphologic assessment of adnexal masses.
authors.affiliation: Department of Obstetrics and Gynecology, Clínica Universitaria de Navarra, Avenida Pio XII 36, Pamplona, Spain. jlalcazar@unav.es
authors.forename: Juan Luis
authors.initials: JL
authors.lastname: Alcázar
authors.forename: Manuel
authors.initials: M
authors.lastname: García-Manero
authors.forename: Rosendo
authors.initials: R
authors.lastname: Galván
mesh_terms: D000291:Adnexal Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography