OP16.03: Reproducibility of different patterns of benign ovarian masses assessed by transvaginal ultrasonography evaluated by several operators with different degree of experience

To evaluate the intraobserver and interobserver agreement for identifying different kinds of benign cysts using typical B-mode ultrasonographic patterns, and to perform an external validation of the proposed ultrasonographic patterns. Digitally stored B-mode sonographic images, from a random sample of 98 women with an adnexal mass submitted to surgery after a B-mode transvaginal sonography, were evaluated by five different examiners with different degrees of experience. A mass was considered benign when it had a typical benign appearance based on universally accepted B-mode ultrasonographic patterns, as in cases of endometrioma, serous cyst, and cystic teratoma. Intraobserver and interobserver agreement according to the level of experience were assessed by calculating the kappa index. Intraobserver agreement was good or very good for all examiners and for all patterns (kappa = 0.71–1), except for dermoid cysts for highly experienced operators, that shows moderate agreement (kappa = 0.42). Interobserver agreement was good for all experts for endometrioma (kappa = 0.66–0.78) and very good for serous cysts (kappa = 0.82–1) while it was moderate or good for cystic teratoma (kappa = 0.51–0.72). Interobserver agreement between moderately and highly experienced operators was moderate (kappa = 0.52) for teratoma, but very good for endometrioma (kappa = 0.88) and serous cysts (kappa = 0.82). The diagnostic performance for different kind of benign cysts and for each examiner is shown in the Table. Our results indicate that typical patterns of benign masses using B-mode transvaginal utrasonography are very highly reproducible even in moderately experienced examiners. More experience was associated with better interobserver agreement. Regarding the diagnostic performance of different patterns, it can be considered acceptable, except for moderately and highly experienced operators for teratoma.