21st World Congress on Ultrasound in Obstetrics and Gynecology Oral poster abstracts borderline or cancer on histology, these women were deemed to have had unnecessary laparoscopic surgery. Results: 73 women were diagnosed with a total of 86 ovarian cysts. 66/73 (90.4%) women were selected for laparoscopy and 7 (9.6%) were selected for laparotomy. Two women who had benign ovarian cysts on TVS were found to have borderline on histopathology. On histological examination, 70 (81.4%) ovarian cysts were benign; 16 (18.6%) ovarian cysts were borderline/malignant ovarian cysts. The operation was successfully completed laparoscopically in 63/66 (95.5%) cases. The pre-operative TVS assessment predicted the successful outcome of advanced laparoscopic surgery with a sensitivity of 98.4%, specificity of 66.7%, PPV 95.5% and NPV 85.7%. Conclusions: Although the numbers are very small, a detailed pre- operative TVS is essential in planning and predicting the feasibility of advanced laparoscopic surgery in women with adnexal lesions. OP24.04 Validation of pelvic masses score (PMS) in the preoperative evaluation of adnexal masses A. Rossi , L. Forzano, E. Vogrig, F. Gubana, P. Leon, P. Veronese, D. Marchesoni Clinica Ostetrica Ginecologica, Universit ` a degli Studi di Udine, Udine, Italy Objectives: The aim of this study was to validate the ability of pelvic masses score (PMS) to discriminate between non-invasive lesions and invasive malignant adnexal masses, and to compare its performance with the two last versions of the risk of malignancy index (RMI 3–4). Methods: Since 1990, four versions of RMI have been validated in different clinical studies. RMI 4 includes also tumor size as an additional parameter. PMS takes into account the ultrasound morphological pattern, the characteristic of vascular distribution, the value of resistance index (RI) at the Doppler flussimetry evaluation of the pelvic mass, CA 125 serum level and the menopausal status of the patient. Ultrasonographic characteristics, menopausal status, serum CA 125 level were registered preoperatively and combined into RMI 3–4 and PMS score. The cut-off of PMS, RMI-3, RMI-4 were considered respectly 29, 200 and 450. The performances of RMI 3–4 and PMS were assessed and statistically tested for differences. All the women were operated and the istologic results were compared with the preoperative evaluation. Results: A total of 104 women admitted to our department between January 2008 and December 2010 for surgical exploration of pelvic masses were included. In our population there were 46 cases of malignant adnexal masses: PMS defined as malignant case 44 masses, RMI-3 36 and RMI-4 37 cases. The RMI-3 had a sensitivity of 76.2%, specificity of 93.5%, positive and negative predictive values of 89.0% and 85.0%. The RMI-4 had a sensitivity of 71.4%, specificity of 95.2%, positive and negative predictive values of 91.0% and 83.0%. The PMS had a sensitivity of 95.2%, specificity of 42.0%, positive and negative predictive values of 56.6% and 92.9%. Conclusions: PMS was more accurate in predicting invasive malignancy than both RMI-3 and RMI-4. OP24.05 Intra- and inter-observer reproducibility of Doppler ultrasound features in adnexal masses L. Zannoni 1,2 , L. Savelli 1 , L. Jokubkiene 2 , A. Di Legge 3 , G. Condous 4 , A. Testa 3 , P. Sladkevicius 2 , L. Valentin 2 1 Gynaecology and Reproductive Medicine Unit, S.Orsola Malpighi Hospital, University of Bologna, Bologna, Italy; 2 Obstetrics and Gynaecology Department, Malm ¨ o University Hospital, Lund University, Malm ¨ o, Sweden; 3 Obstetrics & Gynaecology, Catholic University of the Sacred Heart, Rome, Italy; 4 Early Pregnancy and Advanced Endosurgery Unit, Nepean Clinical School, University of Sydney, Sydney, NSW, Australia Objectives: To determine intra- and inter-observer reproducibil- ity/reliability of assessment of the color content in adnexal masses at color/power Doppler ultrasound examination. Methods: Videoclips with color/power Doppler information of 103 adnexal masses were evaluated independently twice by 4 experienced and 3 less experienced ultrasound examiners. The IOTA color score and semiquantification of the color content on a 100 mm visual analogue scale (VAS score) were assessed. Intraobserver repeatability was evaluated for each observer. Interobserver reproducibility was evaluated for the 4 experienced (6 pairs) and for the 3 less experienced observers (3 pairs). Results for color score were expressed as agreement (%) and weighted Cohen’s kappa (k) and presented as the mean (range) of the respective pairs. Results for VAS score were expressed as mean difference ± 2SE, limits of agreement (LoA) and the intraclass correlation coefficient (ICC), the ICC being presented as the mean (range) of the respective pairs. Bland-Altman plots were drawn. Results: Intraobserver agreement for color score was 79% (70–82.5), k .78 (.71–.82). Interobserver agreement was 60% (48–76), k .60 (.52–.75) for experienced and 64% (56–76), k .63 (.56–.76) for less experienced observers. The intraobserver ICC for VAS score was .88 (.80–.92) and intraobserver differences did not change with increasing VAS values. For 6 of 7 observers there was no systematic difference between the 1 st and 2 nd measurement but LoA were wide. The interobserver ICC for experienced examiners was .84 (.80–.88), for less experienced .82 (.78–.85). A systematic difference in VAS score between observers was found in 7 of 9 pairs of examiners, LoA were wide. 2 of 9 Bland Altman plots depicting differences between observers showed that the differences changed with the magnitude of the VAS score. Conclusions: Intra-observer and inter-observer reproducibility of color score were good and fair, respectively. Intra- and inter-observer reproducibility of VAS score was poor, even though reliability (ICC) was good. OP24.06 Three-dimensional volume off-line analysis as compared to real-time ultrasound for assessing adnexal masses J. Alcazar 1 , A. Iturra 2 , S. Guerriero 3 1 Obstetrics and Gynecology, University of Navarra, Pamplona, Spain; 2 Obsterics and Gynecology, Clinica Indisa, Santiago, Chile; 3 Obsterics and Gynecology, Ospedale San Giovanni di Dio, University of Cagliari, Cagliari, Italy Objectives: To assess the agreement between three-dimensional volume off-line analysis as compared to real-time ultrasound for assessing adnexal masses. Methods: Ninety-nine non-consecutive women diagnosed as having an adnexal mass were assessed by transvaginal power Doppler ultrasound. One single examiner performed all ultrasound examinations. Based on pattern recognition analysis of B-mode findings a presumptive diagnosis (benign or malignant) was provided after real-time ultrasound was performed. Once real-time was done a 3D volume of the adnexal mass was acquired and 126 Ultrasound in Obstetrics & Gynecology 2011; 38 (Suppl. 1): 56–167