Three-Dimensional Power Doppler Vascular Network Assessment of Adnexal Masses Intraobserver and Interobserver Agreement Analysis

Objective. The purpose of this study was to assess intraobserver and interobserver agreement for tumor vascular network evaluation as assessed by 3-dimensional (3D) power Doppler sonography for discriminating benign from malignant adnexal masses. Methods. Stored 3D power Doppler angiographic volume data from 39 women with a diagnosis of a vascularized adnexal mass who were evaluated and treated at our institution were retrieved from our database for analysis. Two different examiners (observer A, with 6 years of experience in 3D sonography; and observer B, with 1 year of experience) reviewed 3D sonograms blinded to each other. Three-dimensional vascular network reconstruction was done with surface rendering in the color mode. Malignancy was considered in the presence of at least 2 of the following: irregular branching, vessel caliber changes, microaneurysms, and vascular lakes. A definitive histologic diagnosis was obtained in all cases. Intraobserver and interobserver agreement rates were estimated by calculating the κ index. Results. Twenty (51%) tumors were malignant, and 19 (49%) were benign. Intraobserver agreement was good for observer A (κ = 0.69) and moderate for observer B (κ = 0.54). Interobserver agreement was moderate (κ = 0.49). Conclusions. We found intraobserver and interobserver agreement to be moderate for 3D power Doppler assessment of the vascular network in adnexal masses. Key words: Doppler sonography; ovarian neoplasms; reproducibility of results; sonography; 3-dimensional imaging.