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O-RADS Ultrasound Calculator – ACR Guidelines


Ovarian lesions


Normal Ovary

Classic







Refer ACR ORADS US Chart Below

You can hover over/click a few tabs for illustrations for eg. Normal ovaries, classic lesions and color score.

Images for reference have been sourced from the original white paper of the ACR. You can access the full article here: O-RADS US Risk Stratification and Management System: A Consensus Guideline from the ACR Ovarian-Adnexal Reporting and Data System Committee.

ORADS Ultrasound Chart

ACR O-RADS Ultrasound Chart
ACR O-RADS Ultrasound Chart

What is the ORADS Classification System

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 :

In this YouTube video titled “O-RADS for Ultrasound: Why, What, When and How to Use and Report,” Dr. Strachowski emphasizes the need for a standardized lexicon when diagnosing ovarian cancer via ultrasound due to the rare and hard-to-diagnose nature of the disease. The O-RADS system provides a solution to the problem and includes six categories with recommendations for each category’s respective management. The speaker discusses how to manage patients depending on their likelihood of malignancy, lesion size, and patient’s menopausal status, among other factors. Additionally, the speaker demonstrates the use of O-RADS through multiple ultrasound case examples and encourages the use of appropriate lexicon and charts when reporting ultrasound results using O-RADS.

O-RADS Ultrasound – Learn from Examples:

Frequently asked questions about ORADS Ultrasound:

The ACR ORADS ultrasound educational series covers frequently asked questions about the ORADS system in this video. Experts discuss topics such as the terminology used for Solid Smooth and Solid Irregular lesions in Risk Categories 3, 4, and 5, the role of spectral doppler, and the definition of ascites. The video also highlights differences between O-RADS and other systems like LI-RADS and emphasizes the importance of consulting an ultrasound specialist for a higher level of characterization. Two sample reports are presented to illustrate how non-specialist imagers and ultrasound specialists differ in reporting and management recommendations.

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.

References:

  1. O-RADS US Risk Stratification and Management System: A Consensus Guideline from the ACR Ovarian-Adnexal Reporting and Data System Committee.
  2. A simplified approach to ovarian lesions based on the O-RADS US risk stratification and management system

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About the Author


Dr. Amar Udare, MD, DNB

Dr Amar Udare 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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