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Three-Dimensional Sonographic Morphologic Assessment of Adnexal Masses

A Reproducibility Study

Department of Obstetrics and Gynecology, Clínica Universitaria de Navarra, School of Medicine, University of Navarra, Pamplona, Spain.

Address correspondence to Juan Luis Alcázar, MD, Department of Obstetrics and Gynecology, Clínica Universitaria de Navarra, Avenida Pio XII 36, 31008 Pamplona, Spain. E-mail: jlalcazar{at}unav.es

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 index. Results. Twenty-seven (33%) tumors were malignant, and 55 (67%) were benign. Intraobserver agreement for both examiners was good ( = 0.78 and 0.72, respectively). Interobserver agreement was also good ( = 0.70). Conclusions. Three-dimensional sonography is a reproducible technique for morphologic assessment of adnexal masses.

Key Words: ovarian tumor • reproducibility • sonography • 3-dimensional sonography

Abbreviations: CI, confidence interval • NPV, negative predictive value • PPV, positive predictive value • 3D, 3-dimensional • 2D, 2-dimensional

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