DIAGNOSTIC EFFICACY OF OVARIAN-ADNEXAL REPORTING AND DATA SYSTEM (O-RADS) -ULTRASOUND TO DISTINGUISH BENIGN AND MALIGNANT ADNEXAL MASSES IN A TERTIARY CARE HOSPITAL
Authors: Bharath Naidu Arige Raj , Rawoof Mohd Abdul , Poorna Sasank Karanam , Lokanandi Peethamber , Sohail Syed Aamir , Joshi Devesh , Preethi Bojanapally 
Published: December 2024

Introduction: The ADNEXA is collective term for Ovary, Fallopian Tubes and Broad Ligaments. In general
practice, adnexal lesions are routinely encountered, both benign and malignant1. Ultrasound is a rapid,
relatively inexpensive and a non-invasive modality2 . Trans abdominal and trans vaginal ultrasound (grey scale and Doppler
ultrasonography) are rst modality of choice for evaluating adnexal masses1. Transabdominal ultrasonography is also useful
to look for secondary changes like hydroureteronephrosis, peritoneal involvement and ascites3.Ultrasound diagnosis of solid
vascular adnexal lesions and cystic adnexal lesions with solid components having good vascularity, with elevated serum
markers can help in prompt referral to a gynaecologic oncologist 1. The ovarian - adnexal reporting and data system
Ultrasound(O-RADS US) uses standard lexicon, incorporates all classes of risk and also management strategy for evaluation
of ovarian and other adnexal masses4.It is relatively new and introduced in the year in 2018 by an International
Multidisciplinary cavity, comprising clinicians and researchers from the elds of Radiology, Gynaecology, Pathology and
Gynaecologic Oncology. To evaluate the diagnostic efcacy of ORADS-US in differentiating benign and Aim/Purpose:
malignant adnexal lesions with histopathological correlation. This was a retrospective and Material And Methods:
prospective analytical study conducted at Apollo hospital, Jubilee hills, Hyderabad. A USG Philips Afniti 70 and 50 machines
was used.Ultrasound reports of patients who were diagnosed with adnexal lesions will be retrieved from the medical records of
the radiology department. Ca-125 and histopathological reports for those patients will be collected and interpreted. All
patients referred to Radiology Department with clinical suspicion of adnexal masses lower abdominal pain will be screened.
Results: A total of 55 patients with adnexal lesions were included and histopathological diagnosis was obtained in all cases,
serving as the gold standard. The sensitivity, specicity, PPV, NPV, and accuracy of the O-RADS classication system were
found to be 88.5%, 96.6%, 95.8%, 90.3%, and 92.7%, respectively. The sensitivity, specicity, PPV, NPV, and accuracy of the IOTASR classication system were 84.6%, 96.6%, 95.7%, 87.5%, and 90.9%, respectively. we found that 0-RADS compares favourably
with IOTA-SR. Specically, O-RADS showed slightly higher sensitivity and accuracy with similar specicity when compared to
IOTA-SR. In our study, all the indeterminate lesions were considered malignant. CA-125 levels were found to be increased in
most of the cases that were assigned O-RADS 4 and O-RADS 5 and later conrmed to be malignant on histopathology.
Conversely, CA-125 levels were low in three cases that were assigned O-RADS 4 and O-RADS 5 but were proven to be
malignant on histopathology. In conclusion, combining the serum levels of CA125 with ultrasound feat Conclusion: ures may
have a more signicant diagnostic value in distinguishing benign from malignant ovarian lesions. Nevertheless, it cannot be
solely relied upon as an indicator, as CA-125 levels may also be elevated in certain benign ovarian lesions. A comprehensive
approach that considers both CA-125 and ultrasound ndings is essential for accurate diagnosis and management.