Background: Females lifetime chance of developing an ovarian tumour is 6-7%. The relative prevalence of ovarian tumours varies across Western and Asian countries. The prompt and precise detection of ovarian masses has a significant influence on long-term survival.

Objective: To determine the diagnostic accuracy of ultrasound in differentiation of ovarian masses taking histopathology as gold standard.

Methodology: This analytical, cross-sectional study was conducted in Radiology Department of Lady Aitchison Hospital, Lahore. 209 females with ages between 20 and 65 years who had clinical sign and symptoms of abdominal pain, tenderness, abnormal uterine bleeding, post-menopausal bleeding, abdominal bloating or swelling, lower back pain, severe or sharp pelvic pain, fever, faintness or dizziness or subjects who had ovarian mass detected on ultrasound were included in the study. Pregnant females and patients with recent abdominal or pelvic surgery and patients with any detectable pathology other than ovarian were excluded from the study. Data was collected after taking consent. Trans abdominal and Doppler ultrasound was done on all subjects. On Ultrasound Consistency, Locularity, Papillary structures, Ascites and Vascularity of Ovarian masses were seen to differentiate between benign and malignant.

Results: According to the results mean and standard deviation of age was 37.36 ± 11.4 years. 174(83.3%) patients had benign ovarian masses whereas 35(16.7%) had malignant ovarian masses which were detected on ultrasound. According to the results, the sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value, and the Accuracy on ultrasound was 84.62%, 92.90%, 62.86%, 97.70%, and 91.87% respectively.

Conclusion: Study concluded that ultrasound is a reasonably accurate diagnostic tool for the diagnosis of ovarian masses. Overall, ultrasound can be a useful tool in the initial evaluation of ovarian masses, but it may need to be supplemented with additional diagnostic tests to confirm the diagnosis.

Key words: Ultrasonography, Histopathology, Ovarian cancer, ovarian cysts, Benign, Malignant.