USG Evaluation of Ovarian Neoplasm with O-RADS Scoring System and Histopathological Correlation

Abstract

 Introduction: Ovarian neoplasms are challenging to diagnose due to their diverse types and clinical behaviors. The Ovarian-Adnexal Imaging Reporting and Data System (O-RADS) standardizes the evaluation of ovarian masses using ultrasound, helping to categorize lesions and guide clinical decision-making for better management. Aim: This study aims to evaluate the sensitivity and specificity of the O-RADS scoring system in identifying ovarian neoplasms and to correlate these scores with histopathological results. Materials and Methods: This prospective study was conducted at Yenepoya Medical College Hospital, Mangalore, involving 58 female patients with lower abdominal pain and menstrual irregularities. Ultrasound exams were performed using a SAMSUNG HS70A device, and ovarian lesions were classified using the O-RADS scoring system. Patients with O-RADS scores of 2 or higher underwent staging laparotomy, and their histopathological results were compared with the O-RADS scores. Results: The mean age of the patients was 45.18 years (SD ± 12.10), with ages ranging from 21 to 66 years. Abdominal pain was the most common symptom (44.8%). O-RADS scores were distributed as follows: O-RADS II (3.4%), O-RADS III (44.8%), O-RADS IV (39.7%), and O-RADS V (12.1%). Histopathological findings included endometriotic cysts (19%), benign serous cystadenomas (13.8%), and high-grade serous carcinoma (8.6%). The O-RADS scoring system demonstrated a sensitivity of 93.55% and specificity of 92.59%, with a strong positive correlation (Spearman's rho = 0.861, p = 0.0001) between O-RADS scores and histopathological results. Conclusion:The O-RADS scoring system shows high sensitivity and specificity in assessing ovarian neoplasms' malignancy risk, with a strong correlation to histopathological findings. This supports its clinical value for early detection and improved management, aligning with existing literature on its reliability and accuracy.