Diagnostic Performance and Accuracy of Ovarian-Adnexal Reporting and Data System Ultrasound Risk Score- A Prospective Cohort Study

Abstract

Introduction: Adnexal malignancies are a leading cause of mortality in gynaecologic cancers, posing significant diagnostic challenges. Ultrasonography (USG) is the primary imaging modality, and the development of the Ovarian-Adnexal Reporting and Data System Ultrasound (O-RADS US) aims to provide standardised interpretations to assist in management decisions. Aim: To evaluate the effectiveness of using the O-RADS classification system in diagnosing and characterising adnexal lesions. Materials and Methods: This single-centre prospective cohort study was conducted at the Department of Radiodiagnosis, Sri Guru Ram Das Charitable Hospital attached to Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India from January 1, 2023, to March 31, 2024. The study included 50 patients with adnexal mass lesions from all age groups. All participants underwent transabdominal/ transvaginal ultrasonographic examinations, with Colour Doppler assessment included. The O-RADS classification system was employed to assess and characterise the adnexal mass lesions. The diagnostic accuracy of the O-RADS US risk score was determined. Statistical analysis was conducted using Statistical Packages for Social Sciences (SPSS) version 24.0 to calculate the sensitivity, specificity, accuracy, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) for O-RADS US results in diagnosing ovarian masses. Results: The patients’ ages ranged from 18 to 83 years, with a mean age of 41.68±15.51 years. The cohort included 35 premenopausal and 15 postmenopausal individuals. The most common indication for USG was pelvic pain, observed in 15 out of 50 patients, representing 30% of the study cohort. The O-RADS sensitivity for the detection of ovarian cancer was 88.89%, with a specificity of 93.75%, NPV of 93.75%, and PPV of 88.89%, with an accuracy of 92%. These results were achieved by keeping O-RADS score of 4 as the cutoff for malignancy. Conclusion: The O-RADS US is effective in the risk stratification of ovarian lesions and has a high diagnostic performance. Implementing these guidelines in clinical practice could be beneficial for managing adnexal lesions.