Abstract

This study was carried out to determine the accuracy of diagnosis of ovarian tumors by different levels of confidence and experience of ultrasound operators, and the association of histological diagnosis with confidence of ultrasound operators. Ultrasound images of representative cases of benign, borderline and invasive malignant ovarian tumors were independently evaluated by 4 experts and 4 trainers. The operators categorized the ovarian tumor into benign, borderline or invasive malignant, and they also gave a score which indicated the degree of confidence when they made diagnosis. The diagnostic accuracy in differentiating benign, borderline and invasive malignant ovarian tumors were calculated depending based on the level of confidence when diagnosis. 500 images of subjects histological diagnosed with ovarian tumor were examined. The confidence score of experts was significantly higher than that of trainees (p<0.05). The diagnostic accuracy was significantly increased with the raising level of confidence (test for trend, p<0.05). The borderline tumor was seemed difficult to diagnose, and had the lowest accuracy, sensitivity and specificity compared to benign and primary invasive tumors. The experts showed the higher accuracy (88.5) than that of trainees (72.5). The confidence score of experts was positive related to diagnostic accuracy, with the contingency coefficient for benign, borderline and primary invasive of 0.62, 0.33 and 0.56. Our study indicated the accuracy of expert ultrasound depends on the degree of confidence, and the borderline type of ovarian tumor showed the difficult to diagnose.

Key words: Ultrasound diagnosis, diagnostic confidence, ovarian tumors, ultrasound experience.