MRI-based O-RADS reliable tool for risk stratification and management of ovarian pathology: Study
Ovarian pathology, which includes a wide range of benign and malignant conditions, poses a major diagnostic challenge in women’s health. Accurate and timely diagnosis is essential for risk stratification and effective management, particularly as ovarian cancer ranks among the top ten cancers affecting women in India.
Magnetic Resonance Imaging (MRI) has become a valuable diagnostic tool in assessing ovarian lesions, providing high-resolution imaging to support accurate diagnoses. The recent development of the Ovarian Imaging Reporting and Data System (O-RADS) aims to standardize MRI interpretations, offering a structured approach to diagnosing and managing ovarian conditions. This study evaluated the accuracy and utility of MRI-basedO-RADS, correlating its findings with histopathological examination and serum tumour markers to validate its role in clinical practice. Precise risk stratification is crucial for clinical decision-making, enabling differentiation between benign and malignant lesions. Therefore, this study aimed to assess the effectiveness of O-RADS in improving lesion characterization, establishing standardized diagnostic protocols, enhancing interdisciplinary communication, and ultimately optimizing the management of ovarian pathology.
This prospective observational study involved 50 patients suspected of having ovarian or adnexal pathology. All patients underwent MRI using a 1.5 Tesla system, with imaging findings evaluated based on the O-RADS scoring system. The MRI results were correlated with histopathological examination and serum tumour marker levels. Diagnostic performance was assessed by calculating sensitivity, specificity, positive predictive value, negative predictive value, and overall diagnostic accuracy. Statistical analysis was performed using SPSS version 23.0, and agreement between MRI, histopathology, and tumour markers was evaluated using correlation coefficients and contingency tables.
The study demonstrated that the MRI-based O-RADS demonstrated high diagnostic accuracy in distinguishing between benign and malignant ovarian lesions with sensitivity of 92% and specificity of 85%. MRI findings showed strong correlation with histopathological results (p < 0.001), with O-RADS scores accurately predicting malignancy in 92% of cases. Serum tumour markers, particularly CA-125, further enhanced diagnostic precision when combined with MRI findings. O-RADS was particularly effective in risk stratification, correctly classifying high-risk patients for malignancy and reducing unnecessary surgical interventions in low-risk cases.
This study establishes the MRI-based Ovarian-Adnexal Reporting and Data System (O-RADS) as a valuable tool for the evaluation of ovarian pathology. With high sensitivity and negative predictive value, O-RADS ensures accurate malignancy detection and reduces missed diagnoses, providing confidence in its use for ruling out benign cases. However, its moderate specificity highlights the need for integration with complementary diagnostic methods to improve accuracy and minimize unnecessary interventions.
The findings emphasize the importance of O-RADS in improving risk stratification, guiding timely interventions for high-risk lesions, and avoiding unnecessary procedures for low-risk cases. Future research should validate these findings across diverse populations and explore advanced techniques like artificial intelligence and radiomics to enhance lesion characterization. O-RADS MRI offers a promising framework to standardize ovarian lesion management, optimize clinical workflows, and enhance patient care. With continued research and refinement, it can significantly contribute to improving outcomes in gynaecological oncology.
Source: Prabhu et al. / Indian Journal of Obstetrics and Gynecology Research 2025;12(2):310–317
