Diagnostic Accuracy of Ultrasound O-Rads Classification in Differentiation of Benign and Malignant Ovarian Lesions Keeping MRI Pelvis as Reference Standard
DOI:
https://doi.org/10.37762/jgmds.12-4.757Keywords:
Ovarian Neoplasms, Ultrasonography, Magnetic Resonance Imaging, O-RADS, Diagnostic Accuracy, Sensitivity and SpecificityAbstract
OBJECTIVES
This study aimed to evaluate the diagnostic accuracy of the ultrasound O-RADS classification for distinguishing between malignant and benign ovarian lesions, using MRI of the pelvis as the reference standard.
METHODOLOGY
A cross-sectional study was conducted, enrolling 169 women with suspicious adnexal masses. All participants underwent standardised ultrasound examinations (with O-RADS scoring) and MRI of the pelvis (with O-RADS MRI scoring). Diagnostic performance metrics, including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), overall accuracy, and the area under the receiver operating characteristic curve (AUC), were calculated.
RESULTS
The prevalence of malignancy was 29.0%. Ultrasound O-RADS demonstrated a sensitivity of 83.7% (95% CI: 76.2-89.5%), specificity of 85.0% (95% CI: 78.3-90.1%), PPV of 69.5%, NPV of 92.7%, and overall accuracy of 84.6%. The AUC was 0.91 (95% CI: 0.86-0.95). Performance was superior in postmenopausal women and for larger lesions (greater than 5 cm in diameter). False positives occurred primarily with hemorrhagic cysts and endometriomas.
CONCLUSION
Ultrasound O-RADS classification demonstrates high diagnostic accuracy, particularly an excellent NPV, for evaluating adnexal masses. It serves as a reliable first-line triage tool, potentially reducing unnecessary MRI referrals in settings with limited resources.
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Copyright (c) 2025 Mehreen Khan, Mehreen Samad, Muneeb Ur Rehman, Hafiza Ayesha Jawaid, Shnaza Ijaz, Faryal Shah, Naila Tamkeen
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