# GI-RADS — Gynecologic Imaging Reporting and Data System

> Five-category transvaginal-ultrasound framework for one adnexal mass, combining pattern recognition, a count of defined suspicious features and estimated malignancy bands. Preserve the original GI-RADS definitions and risk ranges; do not translate a category number into O-RADS, IOTA ADNEX or a treatment order.

**Situação:** vigente · **Órgão:** Ovário e anexos · **Órgão emissor:** Amor et al. / gynecologic ultrasound literature · **Versão:** 2009 proposal; 2011 multicenter validation; 2021 consensus context · **Ano:** 2011

> ⚠️ Uma versão mais nova pode existir (em revisão).

## Procedência e vigência
- Família: léxico
- Tipo de lógica: flat
- Modalidade: US
- Fonte primária: Amor F, Alcázar JL, Vaccaro H, et al.. GI-RADS reporting system for ultrasound evaluation of adnexal masses in clinical practice: a prospective multicenter study (2011) — https://doi.org/10.1002/uog.9012
- Última verificação: 2026-07-24
- Última checagem: 2026-08-12

## Lógica de decisão
Use the exact original category definitions and estimated risk bands. Count the five defined suspicious-feature groups explicitly; GI-RADS 5 requires at least three. Keep current O-RADS/IOTA triage and individualized management separate.

## Categorias

| Código | Rótulo | Critérios | Conduta | Risco | Localizador | Verificado |
| --- | --- | --- | --- | --- | --- | --- |
| 1 | GI-RADS 1, definitively benign | GI-RADS 1, definitively benign: a complete ultrasound examination identifies normal ovaries and no adnexal mass. Nonvisualization of an ovary, incomplete coverage or a technically limited examination must not be converted into category 1. | No mass-specific follow-up was suggested in the original framework after a complete normal examination. Symptoms or another clinical indication are managed separately; the numeral is not a general no-follow-up order. | Original estimated probability of malignancy is 0% for the defined no-mass state. This framework estimate is not proof that no pelvic malignancy exists outside the examined adnexa and is not a personal lifetime-risk estimate. | Amor et al. 2011, DOI 10.1002/uog.9012, Table 1 category 1 and original management suggestions; Amor et al. 2009, PMID 19244063, five-category proposal; Timmerman et al. 2021, DOI 10.1002/uog.23635, GI-RADS risk-band summary and current diagnostic context. | ✓ |
| 2 | GI-RADS 2, very probably benign | GI-RADS 2, very probably benign: an adnexal finding with a characteristic functional origin, such as a follicle, corpus luteum or hemorrhagic cyst, on an adequately characterized ultrasound examination. | The 2011 framework suggested follow-up ultrasound for a presumed functional lesion. Contemporary interval and need for follow-up depend on lesion type, size, symptoms, menopausal status and the current institutional system; category 2 alone does not set an interval. | Original estimated probability of malignancy is less than 1%. This is a category band rather than an individualized probability, and a lesion that lacks the required classic functional pattern must not inherit the band. | Amor et al. 2011, DOI 10.1002/uog.9012, Table 1 category 2 and suggested follow-up; Amor et al. 2009, DOI 10.7863/jum.2009.28.3.285, original expectant-management cohort; Timmerman et al. 2021, DOI 10.1002/uog.23635. | ✓ |
| 3 | GI-RADS 3, probably benign | GI-RADS 3, probably benign: a recognizable persistent lesion thought benign, including an endometrioma, teratoma, simple cyst, hydrosalpinx, paraovarian cyst, peritoneal pseudocyst, pedunculated myoma or pelvic-inflammatory-disease pattern, without defined suspicious features. | The multicenter GI-RADS paper suggested laparoscopic surgery for category 3 in its validation-era pathway. That is not a universal contemporary mandate: expert ultrasound, current O-RADS or IOTA guidance, symptoms, size, growth, menopausal status and patient goals determine surveillance or intervention. | Original estimated probability of malignancy is 1-4%. The band assumes that the benign pattern is confidently recognized; observed malignancy proportions from a selected validation cohort are not interchangeable with this estimate or transferable to one patient. | Amor et al. 2011, DOI 10.1002/uog.9012, Table 1 category 3 and original laparoscopic-surgery suggestion; Timmerman et al. 2021, DOI 10.1002/uog.23635, Statements 1-4 favoring expert assessment and validated IOTA models for current triage. | ✓ |
| 4 | GI-RADS 4, probably malignant | GI-RADS 4, probably malignant: a lesion not meeting categories 1-3 and showing exactly one or two defined suspicious findings: thick papillary projections, thick septations, solid areas, ascites, or vascularization within a solid area or papillary projection or centrally within a solid tumor. | The original clinical-practice framework suggested referral to a gynecologic oncologist. Current triage should be prompt and protocol-based, integrating expert ultrasound, clinical factors and an appropriate contemporary model; the category does not itself diagnose cancer or dictate CT, MRI, biomarkers or surgery. | Original estimated probability of malignancy is 5-20%. GI-RADS 4 and 5 are often combined as a high-risk test-positive group, but this category retains its own band and must not be translated into O-RADS 4, whose definitions and risk range differ. | Amor et al. 2011, DOI 10.1002/uog.9012, Table 1 category 4, suspicious-feature footnote and referral suggestion; Timmerman et al. 2021, DOI 10.1002/uog.23635, GI-RADS bands and current expert/IOTA triage statements. | ✓ |
| 5 | GI-RADS 5, very probably malignant | GI-RADS 5, very probably malignant: an adnexal mass with three or more defined suspicious findings among thick papillary projections, thick septations, solid areas, ascites, and suspicious central or solid-component/papillary vascularization. Two findings remain category 4, not 5. | The original framework suggested referral to a gynecologic oncologist. Contemporary work-up and treatment require expert characterization, clinical context and the applicable oncology pathway; GI-RADS 5 is neither pathologic confirmation nor an automatic staging, biopsy or operation order. | Original estimated probability of malignancy is greater than 20%. The lower bound is specific to GI-RADS and is not equivalent to the substantially different O-RADS 5 band; validation-cohort positive predictive values must not be used as a personal probability. | Amor et al. 2011, DOI 10.1002/uog.9012, Table 1 category 5 requiring three or more suspicious findings, feature footnote and referral suggestion; Timmerman et al. 2021, DOI 10.1002/uog.23635, multisociety risk-band and system-boundary context. | ✓ |

### Citações por categoria
- **1**: Amor F, Alcázar JL, Vaccaro H, et al.. GI-RADS reporting system for ultrasound evaluation of adnexal masses in clinical practice: a prospective multicenter study (2011) — https://doi.org/10.1002/uog.9012 · Amor et al. 2011, DOI 10.1002/uog.9012, Table 1 category 1 and original management suggestions; Amor et al. 2009, PMID 19244063, five-category proposal; Timmerman et al. 2021, DOI 10.1002/uog.23635, GI-RADS risk-band summary and current diagnostic context.
- **2**: Amor F, Alcázar JL, Vaccaro H, et al.. GI-RADS reporting system for ultrasound evaluation of adnexal masses in clinical practice: a prospective multicenter study (2011) — https://doi.org/10.1002/uog.9012 · Amor et al. 2011, DOI 10.1002/uog.9012, Table 1 category 2 and suggested follow-up; Amor et al. 2009, DOI 10.7863/jum.2009.28.3.285, original expectant-management cohort; Timmerman et al. 2021, DOI 10.1002/uog.23635.
- **3**: Amor F, Alcázar JL, Vaccaro H, et al.. GI-RADS reporting system for ultrasound evaluation of adnexal masses in clinical practice: a prospective multicenter study (2011) — https://doi.org/10.1002/uog.9012 · Amor et al. 2011, DOI 10.1002/uog.9012, Table 1 category 3 and original laparoscopic-surgery suggestion; Timmerman et al. 2021, DOI 10.1002/uog.23635, Statements 1-4 favoring expert assessment and validated IOTA models for current triage.
- **4**: Amor F, Alcázar JL, Vaccaro H, et al.. GI-RADS reporting system for ultrasound evaluation of adnexal masses in clinical practice: a prospective multicenter study (2011) — https://doi.org/10.1002/uog.9012 · Amor et al. 2011, DOI 10.1002/uog.9012, Table 1 category 4, suspicious-feature footnote and referral suggestion; Timmerman et al. 2021, DOI 10.1002/uog.23635, GI-RADS bands and current expert/IOTA triage statements.
- **5**: Amor F, Alcázar JL, Vaccaro H, et al.. GI-RADS reporting system for ultrasound evaluation of adnexal masses in clinical practice: a prospective multicenter study (2011) — https://doi.org/10.1002/uog.9012 · Amor et al. 2011, DOI 10.1002/uog.9012, Table 1 category 5 requiring three or more suspicious findings, feature footnote and referral suggestion; Timmerman et al. 2021, DOI 10.1002/uog.23635, multisociety risk-band and system-boundary context.

## Referências cruzadas
- _fronteira compartilhada_ → [O-RADS US — Ovarian-Adnexal Reporting and Data System, ultrasound](https://radcommons.laudos.ai/systems/o-rads-us-2020.md) — Both stratify adnexal findings on ultrasound, but their definitions, risk bands and management differ. Never translate GI-RADS 1-5 into O-RADS 1-5 by number.

## Histórico de versões

| Data | Evento | Detalhe | Situação |
| --- | --- | --- | --- |
| 2026-08-12 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-08-11 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-08-10 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-08-09 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-08-08 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-08-07 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-08-06 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-08-05 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-08-04 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-08-03 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-08-02 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-08-01 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-07-31 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-07-30 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-07-29 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-07-28 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-07-27 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-07-26 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-07-25 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2021-06-01 | revised | The ESGO/ISUOG/IOTA/ESGE consensus retained GI-RADS as a described risk system while preferring expert subjective assessment or validated IOTA models for contemporary preoperative discrimination; this is context, not a change to GI-RADS category thresholds. | confirmed |
| 2011-10-01 | revised | The prospective multicenter clinical-practice study validated the structured report, corrected here to DOI 10.1002/uog.9012, and stated the original management suggestions. | confirmed |
| 2009-03-01 | published | Amor and colleagues proposed the five-category transvaginal-ultrasound GI-RADS framework and evaluated it against pathology in 171 women. | confirmed |


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> Conteúdo de referência reescrito. Confira a publicação primária vigente. Não é dispositivo médico nem substitui o julgamento clínico. O radiologista responsável pelo laudo permanece o autor e o responsável.

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