Risk stratification and validation of ultrasound ovarian and adnexal reporting data system: Correlation with clinical follow-up and histopathology

Abstract

Purpose: Diseases pertaining to the reproductive system of the women are becoming increasing common. The first and foremost system in a female body to show systemic dysfunction is the Endocrine system, which in turn affects the menstrual cycle. Thus menstrual abnormalities are becoming increasingly common. Most common gynaecological problems include ovarian cysts, adnexal masses, fibroids, polycystic ovarian disease. Ovarian cancer is the second most common malignancy in women, accounting for 4% of all cancers in the female population.Adnexal masses (mass of the ovary, fallopian tube, or surrounding connective tissues) are a common gynaecological problem. They account for 80% of all gynaecological problems.These masses may be found in females of all ages.Aim: To stratify and assess the risk stratification of adnexal masses on the basis of ORADS and to calculate statistical measures of performance of ORADS with the help of clinical follow up and histopathology.Materials and Methods: Suspected patients with ovarian/adnexal lesions were referred to Radiology department for Ultrasonography. Transabdominal and/ or transvaginal sonography was performed. The lesions were assessed based on ORADS grading system. Subsequently, the lesions were correlated with the HPE reports. Results: This is a prospective observational study conducted in 166 patients. There was a significant positive correlation between the distribution of benign and malignant tumours across ORADS grades and p value of 0.000 was derived indicating extremely significant statistical difference. Conclusions: Ovarian-Adnexal Reporting and Data System US risk stratification and management system had higher sensitivity and specificity for detection of adnexal malignancy in our study. Higher ORADS Grades were had loculated tumours, irregular margins, septations, solid component, and higher echogenicity. In the ORADS Grade 1, 2 and 3, did not have any malignancy. ORADS grade 4 and 5 had higher prevalence of malignancy.