| O-RADS US risk stratification for Ovarian Masses |
| Paper ID : 1251-IGA |
| Authors |
|
Besjona Kodra * Faculy of Medicine
UHO Mbreteresha Geraldine |
| Abstract |
| Background and Aim: The evaluation of ovarian masses poses a diagnostic challenge due to their wide spectrum of benign and malignant etiologies. Ultrasound is the primary imaging modality for initial assessment, yet variability in its diagnostic accuracy persists. While intraoperative findings contribute further insights, histopathology remains the definitive standard for diagnosis. Materials and Methods: We retrospectively analyzed 28 cases of ovarian masses excised via laparoscopy at our institution. Ultrasound characteristics—including lesion size, morphology, presence of septations, vascularity, and solid components—were compared with intraoperative findings such as wall thickness, adhesions, cyst rupture, and ovarian preservation. The O-RADS US classification system was applied and compared with expert subjective assessment. Histopathological diagnosis served as the reference standard. Results: There was high concordance between ultrasound and surgical findings for multilocularity and cyst wall thickness (Cohen’s kappa), with moderate agreement for lesion size and solid components. Endometriotic cysts were more frequently associated with adhesions and rupture. One case of malignancy—a mixed germ cell tumor—was identified. Serous cystadenomas (32%) and endometriomas (21%) were the most prevalent histological types. The sensitivity and specificity of O-RADS US in excluding malignancy were 100% and 93%, respectively, compared to 96% and 49% with expert opinion. Ovarian preservation was achieved in 86% of cases. Conclusions: Key features such as multilocularity, thick septations, solid elements, and increased Doppler flow are critical in differentiating benign from malignant lesions. While ultrasound is a valuable preoperative tool for risk stratification, intraoperative assessment can guide surgical decision-making. Our findings support the utility of O-RADS US as a user-friendly and accurate classification tool, offering the added benefit of standardized management recommendations. |
| Keywords |
| O-RADS , Ovarian, Malignant, Ultrasound, Laparoscopy |
| Status: Accepted |
