Variations in ultrasound reporting on patients referred for investigation of ovarian masses.

Objective: Ultrasound characteristics play an important role in the evaluation and management of patients with an ovarian mass. We sought to quantify the variability in the reporting practices of radiologists in different practice environments.

Method: We carried out a prospective audit of all patients referred to a tertiary care gynaecologic oncology clinic over a three-month period for management of an ovarian mass. Each patient's presenting symptoms, level of CA125 in serum, and previous ultrasound report were reviewed in detail, and both the environment where the ultrasound examination had been performed and the description of important predictive ultrasound characteristics for underlying risk of malignancy were noted. Descriptive statistics were used to summarize demographic variables. Cross-tabulations and chi-square tests were used to detect significant associations between categorical variables.

Results: In the three-month period, 42 patients were referred to our clinic. The most common presenting symptom was abdominal or pelvic pain (65% of patients). Ultrasound examinations had been conducted in private clinics, community hospitals, and teaching hospitals. Significant variations in the reporting were noted. The important ultrasound characteristic most often not reported (approximately 80% of reports) was Doppler flow assessment of the mass. Five reports (12%) did not include information that would be needed to make a recommendation resulting in repeat ultrasound examination. We found no significant variation in reporting practices between private clinics and community hospitals.

Conclusion: Current reporting practices for ultrasound assessments in women with an ovarian mass vary considerably. They could be improved by use of a standardized synoptic reporting template.