Imaging plays an important role in characterizing and risk-stratifying commonly encountered adnexal lesions. Recently, the American College of Radiology (ACR) released the Ovarian-Adnexal Reporting and Data System (O-RADS) for ultrasound and subsequently for magnetic resonance imaging (MRI). The goal of the recently developed ACR O-RADS MRI risk stratification system is to improve the quality of imaging reports as well as the reproducibility of evaluating adnexal lesions on MRI. This review focuses on exploring this new system and its future refinements.
AndreottiRFTimmermanDStrachowskiLM, et al.O-RADS US risk stratification and management system: A consensus guideline from the ACR ovarian-adnexal reporting and data system committee. Radiology. 2020;294(1):168-185.
2.
AmorFVaccaroHAlcazarJLLeonMCraigJMMartinezJ. Gynecologic imaging reporting and data system: A new proposal for classifying adnexal masses on the basis of sonographic findings. J Ultrasound Med. 2009;28(3):285-291.
3.
Van CalsterBTimmermanDValentinL, et al.Triaging women with ovarian masses for surgery: Observational diagnostic study to compare RCOG guidelines with an International Ovarian Tumour Analysis (IOTA) group protocol. BJOG. 2012;119(6):662-671.
4.
GuptaAJhaPBaranTM, et al.Ovarian cancer detection in average-risk women: Classic- versus nonclassic-appearing adnexal lesions at US. Radiology. 2022;303:212338-212610.
5.
SadowskiEAParoderVPatel-LippmannK, et al.Indeterminate adnexal cysts at US: Prevalence and characteristics of ovarian cancer. Radiology. 2018;287(3):1041-1049.
6.
SohaibSAMillsTDSahdevA, et al.The role of magnetic resonance imaging and ultrasound in patients with adnexal masses. Clin Radiol. 2005;60(3):340-348.
7.
ReinholdCRockallASadowskiEA, et al.Ovarian-adnexal reporting lexicon for MRI: A white paper of the ACR ovarian-adnexal reporting and data systems MRI committee. J Am Coll Radiol. 2021;18(5):713-729.
8.
ReinholdCSadowskiEARockallAThomassin-NaggaraI. Authors’ response. J Am Coll Radiol. 2021;18(12):1594-1595.
9.
SadowskiEAThomassin-NaggaraIRockallA, et al.O-RADS MRI risk stratification system: Guide for assessing adnexal lesions from the ACR O-RADS committee. Radiology. 2022;303(1):35-47.
10.
ForstnerRSalaEKinkelKSpencerJAEuropean Society of Urogenital Radiology. ESUR guidelines: Ovarian cancer staging and follow-up. Eur Radiol. 2010;20(12):2773-2780.
11.
SpencerJAForstnerRCunhaTMKinkelKESUR Female Imaging Sub-Committee. ESUR guidelines for MR imaging of the sonographically indeterminate adnexal mass: An algorithmic approach. Eur Radiol. 2010;20(1):25-35.
12.
ForstnerRThomassin-NaggaraICunhaTM, et al.ESUR recommendations for MR imaging of the sonographically indeterminate adnexal mass: An update. Eur Radiol. 2017;27(6):2248-2257.
13.
BernardinLDilksPLiyanageSMiquelMESahdevARockallA. Effectiveness of semi-quantitative multiphase dynamic contrast-enhanced MRI as a predictor of malignancy in complex adnexal masses: Radiological and pathological correlation. Eur Radiol. 2012;22(4):880-890.
14.
DilksPNarayananPReznekRSahdevARockallA. Can quantitative dynamic contrast-enhanced MRI independently characterize an ovarian mass?Eur Radiol. 2010;20(9):2176-2183.
15.
Thomassin-NaggaraIAubertERockallA, et al.Adnexal masses: development and preliminary validation of an MR imaging scoring system. Radiology. 2013;267(2):432-443.
16.
BashaMAAAbdelrahmanHMMetwallyMI, et al.Validity and reproducibility of the ADNEX MR scoring system in the diagnosis of sonographically indeterminate adnexal masses. J Magn Reson Imaging. 2021;53(1):292-304.
17.
PereiraPNSarianLOYoshidaA, et al.Accuracy of the ADNEX MR scoring system based on a simplified MRI protocol for the assessment of adnexal masses. Diagn Interv Radiol. 2018;24(2):63-71.
18.
PereiraPNSarianLOYoshidaA, et al.Improving the performance of IOTA simple rules: Sonographic assessment of adnexal masses with resource-effective use of a magnetic resonance scoring (ADNEX MR scoring system). Abdom Radiol (NY). 2020;45(10):3218-3229.
19.
SasaguriKYamaguchiKNakazonoT, et al.External validation of ADNEX MR SCORING system: A single-centre retrospective study. Clin Radiol. 2019;74(2):131-139.
20.
RuizMLabaugePLouboutinALimotOFauconnierAHuchonC. External validation of the MR imaging scoring system for the management of adnexal masses. Eur J Obstet Gynecol Reprod Biol. 2016;205:115-119.
21.
HottatNAVan PachterbekeCVanden HouteKDenolinVJaniJCCannieMM. Magnetic resonance scoring system for assessment of adnexal masses: Added value of diffusion-weighted imaging including apparent diffusion coefficient map. Ultrasound Obstet Gynecol. 2021;57(3):478-487.
22.
Thomassin-NaggaraIPonceletEJalaguier-CoudrayA, et al.Ovarian-adnexal reporting data system magnetic resonance imaging (O-RADS MRI) score for risk stratification of sonographically indeterminate adnexal masses. JAMA Netw Open. 2020;3(1):e1919896.
23.
Thomassin-NaggaraIBelghittiMMilonA, et al.O-RADS MRI score: Analysis of misclassified cases in a prospective multicentric European cohort. Eur Radiol. 2021;31(12):9588-9599.
24.
Van CalsterBVan HoordeKFroymanW, et al.Practical guidance for applying the ADNEX model from the IOTA group to discriminate between different subtypes of adnexal tumors. Facts Views Vis Obgyn. 2015;7(1):32-41.
25.
AssoulineVDabiYJalaguier-CoudrayA, et al.How to improve O-RADS MRI score for rating adnexal masses with cystic component?Eur Radiol. 2022;32(9):5943-5953.
26.
WengertGJDabiYKermarrecE, et al.O-RADS MRI classification of indeterminate adnexal lesions: Time-intensity curve analysis is better than visual assessment. Radiology. 2022;303:210342.
27.
SahinHPanicoCUrsprungS, et al.Non-contrast MRI can accurately characterize adnexal masses: A retrospective study. Eur Radiol. 2021;31(9):6962-6973.
28.
Thomassin-NaggaraISadowskiERockallAReinholdC. Correspondence on “ESGO/ISUOG/IOTA/ESGE consensus statement on pre-operative diagnosis of ovarian tumors” by Timmerman et al. Int J Gynecol Cancer. 2021;31(10):1394-1395.
29.
AslanSTosunSA. Diagnostic accuracy and validity of the O-RADS MRI score based on a simplified MRI protocol: a single tertiary center retrospective study. Acta Radiol. Epub ahead of print 2021. doi:10.1177/02841851211060413.
30.
LevineD. MRI O-RADS. Learning about the new risk stratification system. Radiology2022;303(1):48-50.
