The American College of Radiology (ACR) developed the Ovarian-Adnexal Reporting and Data System (ORADS) in response to the need for a standardized reporting system for ovarian and adnexal lesions detected by ultrasound.
The ACR ORADS criteria are divided into five categories, which are described below:
ORADS 1: Normal or Negative This category indicates that no abnormal findings were observed during the ultrasound examination of the ovaries and adnexa. In this case, no further imaging or follow-up is required.
ORADS 2: Benign Findings This category indicates the presence of benign findings, such as simple cysts or hemorrhagic cysts, which do not require further evaluation or management.
ORADS 3: Uncertain or Indeterminate Findings This category is used when the ultrasound examination reveals findings that are not clearly benign or malignant. The radiologist may recommend further imaging, such as MRI or CT, or close follow-up with repeat ultrasound examinations to monitor the lesion.
ORADS 4: Suspicious or Likely Malignant This category indicates that the ultrasound examination has revealed suspicious or likely malignant findings. These findings may include solid or complex masses with irregular borders, septations, or papillary projections. In this case, the patient should undergo further evaluation, such as a biopsy or surgical removal of the lesion, to confirm the diagnosis and determine the appropriate treatment.
ORADS 5: Malignant This category is used when the ultrasound examination reveals findings that are highly suspicious for malignancy, such as large solid masses with irregular borders and septations. In this case, immediate referral to a gynecologic oncologist is recommended for further evaluation and management.
It is important to note that the ACR ORADS criteria are not a definitive diagnosis, but rather a standardized reporting system for ovarian and adnexal lesions detected by ultrasound. The final diagnosis and management of these lesions should be made by a team of healthcare providers, including radiologists, gynecologists, and oncologists.
In conclusion, the ACR ORADS criteria provide a standardized reporting system for ovarian and adnexal lesions detected by ultrasound. By categorizing lesions into specific groups based on their characteristics, the ACR ORADS criteria help guide further evaluation and management of these lesions. It is important for healthcare providers to be familiar with these criteria to ensure timely and appropriate diagnosis and treatment of ovarian and adnexal lesions.
You can watch this detailed lecture on O-RADS Ultrasound by Dr. Avni Skandhan for reference:
Check out other radiology useful calculators:
More video tutorials for ORADS Ultrasound evaluation of Ovarian Cysts:
Basics of ORADS Classification for Ultrasound :
O-RADS Ultrasound – Learn from Examples:
Frequently asked questions about ORADS Ultrasound:
For some reason the preferred search term for O-RADS is o’rads. Probably an indexing error.
Disclaimer: The author makes no claims of the accuracy of the information contained herein; this information is for educational purposes only and is not a substitute for clinical judgment.
Dr. Amar Udare is a board-certified radiologist. He is a clinical assistant professor at the University of Calgary. He has a passion for teaching (#FOAMrad and #FOAMed) and has been a semi-finalist for the 2018 and 2020 Aunt-Minnie Most effective Radiology Educator Awards. He has authored multiple peer-reviewed publications which can be accessed on PubMed and Google Scholar.
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