Reliability of ultrasound ovarian-adnexal reporting and data system amongst less experienced readers before and after training

Figure 2 An example of a left ovarian solid lesion misclassified as a typical ovarian dermoid. A: Static gray-scale images; B: Static color Doppler ultrasound images. Static gray-scale and color Doppler ultrasound images shows a solid hypoechoic lesion with a non-uniform (irregular) margin demonstrated on the color Doppler image (Ovarian-Adnexal Reporting and Data System 5). The lesion demonstrates punctate echogenic areas (white asterisk) which are less echogenic than the surrounding pelvic fat (white arrow). Further, the echogenic areas do not fulfill one of the three descriptors required to characterize as a “typical dermoid cyst < 10 cm” according to ovarian-adnexal reporting and data system criteria (2). The hypoechoic lesion with posterior shadowing suggests a fibrous lesion.