Use of ultrasound pattern recognition by expert operators to identify borderline ovarian tumors: a study of diagnostic performance and interobserver agreement

Authors: Yazbek, J.; Ameye, L.; Timmerman, D.; Testa, A. C.; Valentin, L.; Holland, T. K.; Van Holsbeke, C.; Jurkovic, D.

Source: Ultrasound in Obstetrics and Gynecology, Volume 35, Number 1, January 2010 , pp. 84-88(5)

Publisher: John Wiley & Sons, Ltd.

Abstract:

Objective

To assess the accuracy and reproducibility of ultrasound `pattern recognition' for the diagnosis of borderline ovarian tumors by asking experienced ultrasound operators to evaluate representative images of different types of adnexal tumor.

Methods

Digitally stored static two-dimensional B-mode images of representative cases of benign, borderline and invasive malignant ovarian tumors were independently assessed by three expert sonologists who had not performed the original real-time ultrasound examination. The outcome measures included diagnostic accuracy and interobserver agreement in the diagnosis of benign, borderline or invasive malignant ovarian tumors.

Results

One hundred and sixty-six cases were included in the final data analysis. A correct classification was made by all three experts in 83% of the primary invasive cancers, 76% of the benign masses and in 44% of the borderline malignant tumors (P < 0.01). The experts showed a tendency to misclassify borderline tumors as benign rather than primary invasive (ratio of 8 : 1 for Expert A, 4 : 1 for B and 6 : 1 for C). The interobserver agreement between any two experts was very good when they were tested for their ability to discriminate between invasive and non-invasive (benign and borderline) ovarian tumors (Cohen's kappa 0.85-0.88), but poorer for the discrimination between malignant (invasive and borderline) and benign tumors (kappa 0.70-0.78).

Conclusions

The accuracy of ultrasound diagnosis of borderline tumors is lower in comparison with benign and invasive malignant lesions. The diagnostic performance and interobserver agreement are better when the outcomes are dichotomized into non-invasive and invasive malignant lesions, as opposed to the traditional diagnosis of benign and malignant tumors. Copyright © 2009 ISUOG. Published by John Wiley & Sons, Ltd.

Keywords: benign; borderline; interobserver agreement; malignant; ovarian neoplasms; pattern recognition; ultrasonography

Document Type: Research article

DOI: http://dx.doi.org/10.1002/uog.7334

Publication date: 2010-01-01

More about this publication?

• As of January 2010, this journal will no longer be available on IngentaConnect, please visit Wiley InterScience to arrange continued access to this content
• Access this journal at Wiley InterScience
• ingentaconnect is not responsible for the content or availability of external websites

Related content

• In this: publication
• By this: publisher
• In this Subject: Obstetrics & Gynecology ,  Radiology & Imaging
• By this author: Yazbek, J. ;  Ameye, L. ;  Timmerman, D. ;  Testa, A. C. ;  Valentin, L. ;  Holland, T. K. ;  Van Holsbeke, C. ;  Jurkovic, D.

Website © Publishing Technology. Article copyright remains with the publisher, society or author(s) as specified within the article.

• Terms and conditions
• Privacy policy
• Information for advertisers