Ovarian-Adnexal Reporting and Data Systems MR Imaging: Nuts and Bolts

MR imaging plays a key role in the characterization of adnexal lesions of indeterminate malignant potential found at ultrasound. Recently, the Ovarian-Adnexal Reporting and Data Systems (O-RADS) MRI lexicon and scoring system was developed to aid in standardization of reporting and interpretation of adnexal lesions, allowing for risk stratification based on MR imaging findings. This in turn can help improve communication between radiologists and referring providers, and potentially aid the selection of optimal treatment options. This article provides a detailed review of the lexicon and the scoring rubric of the O-RADS MRI risk stratification system.