The diagnosis of ovarian cancer: is color Doppler imaging reproducible and accurate in examiners with different degrees of experience?
OBJECTIVE
To evaluate the reproducibility and accuracy of color Doppler flow location in indeterminate masses after a gray-scale sonography in the diagnosis of ovarian malignancy.


METHODS
Digitally stored color Doppler sonographic images from a random sample of 130 women with an indeterminate adnexal mass submitted to surgery were evaluated by six different examiners with different degrees of experience. A mass was graded malignant if flow was shown within the excrescences or solid areas. Intraobserver agreement and interobserver agreement according to the level of experience were assessed by calculating the kappa index.


RESULTS
Intraobserver agreement was good for all examiners with different degrees of experience (kappa 0.72-0.89). Interobserver agreement was good to moderate for all operators (kappa 0.48-0.71) irrespective of degree of experience. The accuracy was comparable among different operators.


CONCLUSIONS
Our results indicate that color Doppler imaging for detection of adnexal malignancy seems to be a reproducible method even in moderately experienced examiners.
San Giovanni di Dio Hospital, Department of Obstetrics and Gynaecology, University of Cagliari, Cagliari, Italy. gineca.sguerriero@tiscali.it
Stefano
S
Guerriero
Juan Luis
JL
Alcazar
Maria Angela
MA
Pascual
Silvia
S
Ajossa
Betlem
B
Graupera
Lourdes
L
Hereter
Gian Benedetto
GB
Melis
D000290:Adnexa Uteri / Q000000981:diagnostic imaging*; D000328:Adult; D005260:Female; D006801:Humans; D008875:Middle Aged; D015588:Observer Variation; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color / Q000379:methods*