The Ovarian/Adnexal Reporting and Data System for Ultrasound: From Standardized Terminology to Optimal Risk Assessment and Management

• Published in: Canadian Association of Radiologists journal Vol. 74; no. 1; pp. 44 - 57
• Main Authors: Phillips, Catherine H., Guo, Yang, Strachowski, Loretta M., Jha, Priyanka, Reinhold, Caroline, Andreotti, Rochelle F.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-02-2023; SAGE PUBLICATIONS, INC
• Subjects: Female; Humans; Language; Malignancy; Ovarian cancer; Ovarian Neoplasms - diagnostic imaging; Ovarian Neoplasms - pathology; Radiology; Retrospective Studies; Risk Assessment; Risk management; Terminology; Training; Training level; Tumors; Ultrasonic imaging; Ultrasonography - methods; Ultrasound; Validation studies; O-RADS; lexicon; ultrasound; reporting system
• ISSN: 0846-5371; 1488-2361
• DOI: 10.1177/08465371221108057

The American College of Radiology (ACR) Ovarian-Adnexal Reporting and Data System (O-RADS) lexicon and risk assessment tool for ultrasound (US) provides a framework for characterization of ovarian and adnexal pathology with the ultimate goal of harmonizing reporting and patient management strategies. Since the first O-RADS US publication in 2018, multiple validation studies have shown O-RADS US to have excellent diagnostic accuracy, with the majority of these studies using O-RADS 4 as the optimal cut-off for detecting ovarian cancer. Most of the existing validation studies include a dedicated training phase and confirm that ORADS US categories and lexicon descriptors are associated with high level inter-read agreement, regardless of radiologist training level or practice experience. O-RADS US has a similar inter-reader agreement when compared to Gynecologic Imaging Reporting and Data System (GIRADS), Assessment of Different Neoplasias in the adnexa (ADNEX), and International Tumor Analysis Group (IOTA) simple rules. System descriptors have been shown to correlate with expected malignancy rates and the O-RADS US risk stratification system has been shown to perform in the expected range of malignancy risk per category. Further directions will focus on clarifying governing concepts and lexicon terminology as well as further refining risk stratification categories based on data from published validation studies.