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O-RADS US Risk Stratification and Management System: A Consensus Guideline from the ACR Ovarian-Adnexal Reporting and

Rochelle F Andreotti1, Dirk Timmerman1, Lori M Strachowski1

  • 1From the Department of Radiology and Radiological Sciences and Department of Obstetrics and Gynecology, Vanderbilt University College of Medicine, 1161 21st Ave S, #D3300, Nashville, Tenn 37232 (R.F.A.); Department of Obstetrics and Gynecology, University Hospitals KU Leuven, Leuven, Belgium (D.T.); Department of Radiology, University of California, San Francisco, San Francisco, Calif (L.M.S.); Department of Development and Regeneration, KU Leuven, Leuven, Belgium (W.F.); Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium (W.F.); Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Brookline, Mass (B.R.B.); Department of Radiology, NYU Langone Health, New York, NY (G.L.B.); Department of Obstetrics and Gynecology, Queen Charlotte's and Chelsea Hospital, Imperial College London, London, England (T.B.); Department of Radiology, Mayo Clinic, Rochester, Minn (D.L.B.); Department of Radiology, Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, Pa (B.G.C.); Department of Radiology, Brigham and Women's Hospital, Boston, Mass (M.C.F.); Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY (S.R.G.); Department of Radiology, Johns Hopkins University, School of Medicine, Baltimore, Md (U.M.H.); Department of Radiology, Einstein Medical Center, Philadelphia, Pa (M.M.H.); Department of Radiology and Radiological Sciences, Carell Children's Hospital at Vanderbilt, Nashville, Tenn (M.H.S.); Department of Radiology, McGill University Health Centre, Montreal, Canada (C.R.); Department of Obstetrics and Gynecology, University of Wisconsin, Madison, Wis (S.L.R.); Department of Obstetrics and Gynecology, University of Connecticut School of Medicine, Farmington, Conn (B.P.W.); Department of Obstetrics and Gynecology, Mt. Sinai Hospital, University of Toronto, Toronto, Canada (W.L.W.); and Department of Medical Imaging and Department of Obstetrics and Gynecology, University of Toronto, Sunnybrook Research Institute, Toronto, Canada (P.G.).

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The Ovarian-Adnexal Reporting and Data System (O-RADS) US provides consistent risk assessment for ovarian masses. This standardized system improves diagnostic accuracy and guides management recommendations for adnexal lesions.

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Area of Science:

  • Radiology
  • Gynecologic Imaging
  • Oncology

Background:

  • Ovarian and adnexal masses require accurate risk stratification for malignancy.
  • Current interpretation and reporting of adnexal masses can lack consistency and lead to ambiguity.
  • Standardized systems are needed to improve diagnostic accuracy and management recommendations.

Purpose of the Study:

  • To introduce the Ovarian-Adnexal Reporting and Data System (O-RADS) US risk stratification and management system.
  • To enhance consistency and accuracy in reporting ovarian and adnexal masses.
  • To provide standardized management recommendations based on risk categories.

Main Methods:

  • Development of a standardized reporting tool based on the O-RADS US lexicon.
  • Implementation of a six-category risk stratification system (O-RADS 0-5).
  • Integration of a pattern-based approach (North America) and an algorithmic approach (International Ovarian Tumor Analysis - IOTA).

Main Results:

  • The O-RADS US system offers consistent interpretation and reduces ambiguity in US reports.
  • It improves the accuracy of assigning malignancy risk to ovarian and adnexal masses.
  • Standardized management guidelines are proposed for each risk category.

Conclusions:

  • O-RADS US is a comprehensive lexicon and classification system for ovarian and adnexal masses.
  • It unifies risk stratification and management strategies, regardless of the initial approach used.
  • This system aims to optimize patient care through standardized evaluation and management.