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The Ovarian-Adnexal Reporting and Data System (O-RADS) US Score Effect on Surgical Resection Rate
Luyao Shen1, Elizabeth A Sadowski1, Akshya Gupta1
1From the Department of Radiology, Stanford University School of Medicine, 300 Pasteur Dr, H1307, Stanford, CA 94305 (L.S., A.K., N.A., P.J.); Departments of Radiology (E.A.S.) and Obstetrics and Gynecology (E.A.S., L.M.B.), University of Wisconsin School of Medicine and Public Health, Madison, Wis; Department of Imaging Sciences, University of Rochester, Rochester, NY (A.G.); Department of Radiology and Obstetrics and Gynecology, University of Michigan, Ann Arbor, Mich (K.E.M.); Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tenn (K.K.P.L.); Department of Radiology, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pa (H.M.Z.); and Department of Radiology, Brigham and Women's Hospital, Boston, Mass (Y.G.).
Nearly half of surgically resected ovarian lesions (42%) met low-risk O-RADS US criteria, suggesting conservative management could have been an option for these patients without acute symptoms.
Area of Science:
- Radiology
- Gynecologic Imaging
- Oncologic Imaging
Background:
- The Ovarian-Adnexal Imaging Reporting and Data System (O-RADS) US risk score stratifies ovarian lesions.
- Large multicenter studies are lacking on the impact of O-RADS US version 2022 in surgically managed patients.
- This study evaluates the potential for conservative management using O-RADS US in pre-publication cases.
Purpose of the Study:
- To determine the proportion of ovarian/adnexal lesions without acute symptoms that could have been managed conservatively using the O-RADS US version 2022 risk score.
- To assess the retrospective application of O-RADS US risk stratification in patients undergoing surgery for ovarian lesions.
- To evaluate the frequency of malignancy and diagnostic performance of O-RADS US in this cohort.
Main Methods:
- Retrospective multicenter study of 377 patients with ovarian cystic lesions and nonacute symptoms who underwent surgical resection.
- US imaging features and O-RADS US risk scores were recorded by blinded investigators.
- Statistical analysis included Mann-Whitney and Fisher exact tests (P < .05).
Main Results:
- 42% (157/377) of resected lesions received an O-RADS US risk score of 2.
- Of O-RADS US 2 lesions, 54% were nonneoplastic, 45% benign tumors, and <1% malignant.
- An O-RADS US score of 4 predicted malignancy with 94% sensitivity and 64% specificity.
Conclusions:
- A significant proportion (42%) of surgically resected ovarian lesions in non-acute patients met O-RADS US 2 criteria.
- These cases could have potentially benefited from imaging follow-up or conservative management.
- O-RADS US risk score has implications for surgical decision-making in ovarian adnexal lesions.
