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Background  One of the limiting factors for early diagnosis of ovarian neoplasms is the lack of standardized terminology for ultrasound. The Ovarian-Adnexal Reporting and Data System (O-RADS) classification aimed to reduce variability between observers and facilitate communication with attending physicians. Recent studies show that O-RADS has higher sensitivity (96.8%) and specificity (92.8%) compared to other classifications. However, to date, there are no reports on O-RADS correlation with pathology findings.  Objectives  To determine sensitivity and specificity of ultrasound, as a tool for detecting malignant ovarian neoplasms, using the O-RADS compared to pathology reports.  Materials and methods  We evaluated 73 transvaginal ultrasound records with adnexal masses and applied the O-RADS system. Then, we compared against definitive histopathology diagnosis. We calculated sensitivity and specificity using SPSS.  Results  O-RADS sensitivity for detection of ovarian cancer was 52%, with a specificity of 84%, negative predictive value of 79%, and positive predictive value of 60%, with an accuracy of 73%.  Conclusions  In our study, O-RADS classification yielded a higher specificity than sensitivity for malignant vs. benign findings. Hence, we propose that this classification could be useful for tailoring treatment appropriately. O-RADS 0 to 2 may benefit from conservative treatment while O-RADS 3 to 5 may require surgical treatment.

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Sensitivity and Specificity of Ultrasonography Using Ovarian-Adnexal Reporting and Data System Classification Versus Pathology Findings for Ovarian Cancer