O-RADS (Ovarian-Adnexal Reporting & Data System)

What is O-RADS?

O-RADS™ stands for Ovarian-Adnexal Reporting & Data System. It’s a tool healthcare providers use when they find a mass on an imaging test. The tool helps them decide if the mass is low-risk or high-risk for cancer. It also helps them explain the results clearly. Based on the score, they can decide the next step. This may include follow-up testing or surgery.

Providers use O-RADS if they’re trying to diagnose and classify:

• Ovarian cysts: Lesions or masses on your ovaries
• Adnexal masses: Lesions or masses on your fallopian tubes or pelvic ligaments

There are two types of O-RADS depending on the type of imaging:

1. O-RADS ultrasound: Abdominal or transvaginal ultrasound is the main method used in O-RADS. It can show most ovarian and adnexal lesions. The score is based on features such as whether the mass contains fluid or solid tissue and whether it shows blood flow.
2. O-RADS MRI: This type can show more details of the tissue. Healthcare providers may use this if they need more information after an ultrasound. MRI scoring focuses on what the mass looks like after contrast material and the type of tissue it contains.

Both types use the same categories to estimate cancer risk. But the criteria to assign the score are slightly different for MRI. O-RADS uses a scale of 1 (normal) to 5 (high-risk) to estimate cancer risk. In O-RADS MRI, category 0 is rarely used because MRI is usually done after ultrasound and is more complete.

Here is the O-RADS classification system:

The system has follow-up care and treatment recommendations for each risk category. It also contains a list of standardized terms. This helps providers use the same words, so it’s easier to understand the results.

What does O-RADS do?

The purpose of O-RADS is to:

1. Keep interpretations consistent: O-RADS ensures that every healthcare provider in the U.S. uses the same classification process for ovarian and adnexal lesions. This means results will be the same no matter where you live.
2. Improve accuracy: O-RADS reduces your chance of a false positive or a false negative. It gives clear rules on how to interpret features of the mass, like shape, structure or if it contains fluid. It removes guesswork for your provider.
3. Guide next steps: The O-RADS system gives healthcare providers standardized treatment recommendations for each risk category. For example, it can tell your provider whether you need monitoring, follow-up imaging or a referral to an oncologist.

Benefits of O-RADS

The O-RADS system was developed by the American College of Radiology (ACR) to improve how ovarian and adnexal masses are evaluated. It helps your provider:

• Tell the difference between noncancerous (benign) and cancerous (malignant) masses by looking at size, location and appearance
• Use clear, standardized terms so they all communicate results the same way
• Avoid false positives (thinking something is cancerous when it’s not) and false negatives (missing a cancerous mass)
• Decide the next steps in the process (whether it’s repeat imaging, referral to a specialist or something else)