Interobserver agreement in the results of Doppler examinations of extrauterine pelvic tumors

The aim of this study was to evaluate interobserver agreement in the results of Doppler measurements of peak systolic velocity (PSV), time‐averaged maximum velocity (TAMXV) and the color content of tumor scans in extrauterine pelvic tumors. The results of transvaginal color and spectral Doppler examinations of 66 extrauterine pelvic masses obtained by two observers experienced in ultrasonography were compared. Each observer aimed to obtain the highest possible Doppler shift from arteries in the wall, septa and solid parts of each tumor. Tumor vascularization was assessed in terms of the ‘tumor color score’, i.e. the color content of the Doppler scan as rated for the tumor as a whole by each observer on a visual analog scale. The tumors were classified according to arbitrarily chosen cut‐off limits for the tumor color score, the highest tumor TAMXV and the highest tumor PSV. Inter‐class correlation coefficient values for TA MXV and PSV were ≥ 0.75, whereas that for tumor color score was 0.89. Interobserver agreement was complete for the detection of color in tumors (Kappa value 1.0), excellent for the recording of arterial Doppler shift spectra from tumors (Kappa value 0.82)) and moderate or good for classifying tumors based on cut‐off limits for TAMXV, PSV (Kappa values ranging from 0.44 to 0.67) and tumor color score (Kappa values ranging from 0.59 to 0.66). Despite the fact that two observers did not obtain the same absolute values for TAMXV, PSV or tumor color score, the interobserver agreement in the classification of tumors based on cut‐off limits for these variables was good. Therefore, in terms of reproducibility, it should be possible to use Doppler measurements of TAMXV, PSV and tumor color score as clinical variables to characterize extrauterine pelvic masses. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology