P29.04: Reproducibility and comparison of two different methods for performing mean gray value evaluation of cystic content in endometriomas using VOCAL

To compare two different methods (manual sampling of all the cyst and semiautomated spherical sampling from the central part of cyst) for performing mean gray value (MGV) evaluation of cystic content in endometriomas using Virtual Organ Computer-aided AnaLysis (VOCAL). Forty-one volumes from histologically confirmed endometriomas were retrieved from our database for analysis. A single examiner acquired all the volumes. Another operator evaluate all 41 volumes to compare means obtained from two modalities. In addition, to evaluate the reproducibility in a sample of 20 volumes, two different observers calculated the MGV from cyst content using the VOCAL software. For each methods, each examiner was to review the volumes twice, 3 week apart for assessing intraobserver agreement. In addition the observers recorded the time spent performing each analysis. Inter- and intraobserver reproducibility was evaluated for each method using intraclass correlation coefficients (ICC) with 95% confidence interval (CI). There was no difference in the mean MGV using manual (22.211 ± 7.541) and semiautomated modality of sampling (23.840 ± 8.621, P > 0.05; ICC 0.954). The correlation between manual and semiautomated sampling measurement was high with a R of 0.92. According to ICCs to test reproducibility, there was a not significantly different interobserver reliability using manual (0.931; 95% CI, 0.824–0.973) compared with semiautomated modality of sampling (0.924; 95% CI, 0.809–0.970)) ultrasound. Intraobserver reproducibility for both examiners was good (ICC > 0.94). Semiautomated measurements were obtained significantly faster than those by manual evaluation. Both methods seem reliable but the semiautomated method using the sphere should be preferred because less time-consuming and used to discriminate ovarian endometriomas from other unilocular ovarian cysts in premenopausal women.