# O-RADS US — Ovarian-Adnexal Reporting and Data System, ultrasound

> Ultrasound risk stratification and management of adnexal lesions.

**Situação:** vigente · **Órgão:** Ovário e anexos · **Órgão emissor:** American College of Radiology · **Versão:** US 2019 · **Ano:** 2020

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

## Procedência e vigência
- Família: léxico
- Tipo de lógica: flat
- Modalidade: US
- Fonte primária: Andreotti RF, Timmerman D, Strachowski LM, et al.. O-RADS US Risk Stratification and Management System: A Consensus Guideline from the ACR Ovarian-Adnexal Reporting and Data System Committee (2020) — https://doi.org/10.1148/radiol.2019191150
- Última verificação: 2026-07-24
- Última checagem: 2026-08-12

## Categorias

| Código | Rótulo | Critérios | Conduta | Risco | Localizador | Verificado |
| --- | --- | --- | --- | --- | --- | --- |
| 0 | Incomplete evaluation | Incomplete evaluation: the adnexa or lesion cannot be adequately assessed on the available ultrasound study (insufficient/incomplete imaging). | A repeat (or otherwise completed) ultrasound examination is recommended to adequately characterize the adnexa. | — | Criteria: Front Pediatr 2023 (PMC10030612), O-RADS category list ('O-RADS 0: incomplete evaluation'); corroborated appliedradiology.com. Management: PMC9327748 ('O-RADS 0 ... a repeat ultrasound examination is recommended') | ✓ |
| 1 | Normal ovary, physiologic | Normal ovary / definitively benign physiologic finding (e.g., a normal premenopausal ovary, including follicles and corpus luteum); no discrete lesion meeting higher-category descriptors. | No lesion-specific imaging follow-up is necessary for a normal ovary or definitively benign physiologic finding; subsequent care follows the clinical context. | — | Criteria: Front Pediatr 2023 (PMC10030612), O-RADS category list ('O-RADS 1: definitively benign. Normal ovaries'); corroborated appliedradiology.com. Management: PMC9327748 ('O-RADS 1 ... follow-up is not necessary') | ✓ |
| 2 | Almost certainly benign | Almost certainly benign lesion: classic benign appearances such as a simple cyst, classic hemorrhagic cyst, classic dermoid (mature cystic teratoma), classic endometrioma, para-ovarian cyst, peritoneal inclusion cyst, or hydrosalpinx; also unilocular cysts up to about 10 cm with smooth inner walls and no solid component. | For lesions with classic benign ultrasound features, no further evaluation is generally required on identification; certain subtypes warrant short-interval follow-up ultrasound (e.g., larger hemorrhagic cysts and endometriomas) as described in the source. | Almost certainly benign, with less than 1% risk of malignancy. | Risk band from Front Pediatr 2023 (PMC10030612) ('O-RADS 2: almost certainly benign category (<1% risk of malignancy)') and JAMA Netw Open 2022 (PMC9185186) Discussion ('O-RADS US 2 was 0.5%, (<1%; expected)'); descriptors and management from appliedradiology.com O-RADS section and the reproduced ACR O-RADS US Risk Stratification Table (PMC9185186 Figure 1) | ✓ |
| 3 | Low risk of malignancy | Low-risk lesion: e.g., a unilocular cyst 10 cm or larger with smooth inner wall, a multilocular cyst smaller than 10 cm with smooth inner wall and color score 1-3, a unilocular cyst with an irregular inner wall (less than 3 mm), or a smooth-contoured solid lesion of any size with color score 1. | Further characterization by management with an ultrasound specialist or by MRI (the two considered equivalent for O-RADS 3) is recommended; MRI is particularly valuable in postmenopausal patients. | Low risk, 1% to less than 10% risk of malignancy (stated as 1-9% in the corroborating source). | Risk band from Front Pediatr 2023 (PMC10030612) and JAMA Netw Open 2022 (PMC9185186, observed 4.5%); descriptors from reproduced ACR Risk Stratification Table (PMC9185186 Fig 1) and JAMA Table 2. Management: PMC9327748 (US specialist equivalent to MRI for O-RADS 3) and appliedradiology.com ('MRI may be valuable') | ✓ |
| 4 | Intermediate risk of malignancy | Intermediate-risk lesion: e.g., multilocular cyst 10 cm or larger (or any size with color score 4), multilocular cyst with irregular wall/septation, unilocular cyst with a solid component and 0-3 papillary projections (any color score), multilocular cyst with a solid component and color score 1-2, or a smooth-contoured solid lesion with color score 2-3. | Consultation with a gynecologic oncologist is recommended; further characterization by MRI (or an ultrasound specialist, considered equivalent to MRI for O-RADS 3-4) may be used. | Intermediate risk, 10% to less than 50% risk of malignancy. | Risk band: Front Pediatr 2023 (PMC10030612) and JAMA Netw Open 2022 (PMC9185186, observed 11.6%); descriptors from reproduced ACR Risk Stratification Table (PMC9185186 Fig 1) and JAMA Table 2. Management: PMC9327748 ('O-RADS 4 ... consultation with gynecologic oncologist'; US specialist equivalent to MRI for 3-4) | ✓ |
| 5 | High risk of malignancy | High-risk lesion: e.g., unilocular cyst with 4 or more papillary projections (any color score), multilocular cyst with a solid component and color score 3-4, smooth-contoured solid lesion with color score 4, any solid lesion with irregular outer contour (any color score), or any O-RADS 3-5 lesion accompanied by ascites and/or peritoneal nodules. | Direct referral to a gynecologic oncologist is recommended. | High risk, 50% or greater risk of malignancy. | Risk band: Front Pediatr 2023 (PMC10030612) and JAMA Netw Open 2022 (PMC9185186, observed 65.6%); descriptors from reproduced ACR Risk Stratification Table (PMC9185186 Fig 1) and JAMA Table 2. Management: PMC9327748 ('O-RADS 5 ... direct referral to a gynecologic oncologist is recommended') | ✓ |

### Citações por categoria
- **0**: Andreotti RF, Timmerman D, Strachowski LM, et al.. O-RADS US Risk Stratification and Management System: A Consensus Guideline from the ACR Ovarian-Adnexal Reporting and Data System Committee (2020) — https://doi.org/10.1148/radiol.2019191150 · Criteria: Front Pediatr 2023 (PMC10030612), O-RADS category list ('O-RADS 0: incomplete evaluation'); corroborated appliedradiology.com. Management: PMC9327748 ('O-RADS 0 ... a repeat ultrasound examination is recommended')
- **1**: Andreotti RF, Timmerman D, Strachowski LM, et al.. O-RADS US Risk Stratification and Management System: A Consensus Guideline from the ACR Ovarian-Adnexal Reporting and Data System Committee (2020) — https://doi.org/10.1148/radiol.2019191150 · Criteria: Front Pediatr 2023 (PMC10030612), O-RADS category list ('O-RADS 1: definitively benign. Normal ovaries'); corroborated appliedradiology.com. Management: PMC9327748 ('O-RADS 1 ... follow-up is not necessary')
- **2**: Andreotti RF, Timmerman D, Strachowski LM, et al.. O-RADS US Risk Stratification and Management System: A Consensus Guideline from the ACR Ovarian-Adnexal Reporting and Data System Committee (2020) — https://doi.org/10.1148/radiol.2019191150 · Risk band from Front Pediatr 2023 (PMC10030612) ('O-RADS 2: almost certainly benign category (<1% risk of malignancy)') and JAMA Netw Open 2022 (PMC9185186) Discussion ('O-RADS US 2 was 0.5%, (<1%; expected)'); descriptors and management from appliedradiology.com O-RADS section and the reproduced ACR O-RADS US Risk Stratification Table (PMC9185186 Figure 1)
- **3**: Andreotti RF, Timmerman D, Strachowski LM, et al.. O-RADS US Risk Stratification and Management System: A Consensus Guideline from the ACR Ovarian-Adnexal Reporting and Data System Committee (2020) — https://doi.org/10.1148/radiol.2019191150 · Risk band from Front Pediatr 2023 (PMC10030612) and JAMA Netw Open 2022 (PMC9185186, observed 4.5%); descriptors from reproduced ACR Risk Stratification Table (PMC9185186 Fig 1) and JAMA Table 2. Management: PMC9327748 (US specialist equivalent to MRI for O-RADS 3) and appliedradiology.com ('MRI may be valuable')
- **4**: Andreotti RF, Timmerman D, Strachowski LM, et al.. O-RADS US Risk Stratification and Management System: A Consensus Guideline from the ACR Ovarian-Adnexal Reporting and Data System Committee (2020) — https://doi.org/10.1148/radiol.2019191150 · Risk band: Front Pediatr 2023 (PMC10030612) and JAMA Netw Open 2022 (PMC9185186, observed 11.6%); descriptors from reproduced ACR Risk Stratification Table (PMC9185186 Fig 1) and JAMA Table 2. Management: PMC9327748 ('O-RADS 4 ... consultation with gynecologic oncologist'; US specialist equivalent to MRI for 3-4)
- **5**: Andreotti RF, Timmerman D, Strachowski LM, et al.. O-RADS US Risk Stratification and Management System: A Consensus Guideline from the ACR Ovarian-Adnexal Reporting and Data System Committee (2020) — https://doi.org/10.1148/radiol.2019191150 · Risk band: Front Pediatr 2023 (PMC10030612) and JAMA Netw Open 2022 (PMC9185186, observed 65.6%); descriptors from reproduced ACR Risk Stratification Table (PMC9185186 Fig 1) and JAMA Table 2. Management: PMC9327748 ('O-RADS 5 ... direct referral to a gynecologic oncologist is recommended')

## Referências cruzadas
- _encaminha para_ → [O-RADS MRI — Ovarian-Adnexal Reporting and Data System, MRI](https://radcommons.laudos.ai/systems/o-rads-mri.md) — Indeterminate adnexal lesions on ultrasound are escalated to O-RADS MRI.
- _fronteira compartilhada_ → [BI-RADS — Breast Imaging Reporting and Data System, 5th edition](https://radcommons.laudos.ai/systems/bi-rads-2013.md) — Shares the ACR Reporting and Data System framework that BI-RADS established.

## Histórico de versões

| Data | Evento | Detalhe | Situação |
| --- | --- | --- | --- |
| 2026-08-11 | 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 |
| 2026-08-07 | 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 |
| 2026-07-31 | 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 |
| 2026-07-24 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-07-23 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-07-21 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-07-20 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-07-19 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-07-18 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-07-17 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-07-16 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-07-15 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-07-10 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-07-08 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-07-07 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-07-05 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-06-30 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-06-29 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-06-25 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2026-06-24 | revised | Monitored source changed (content_hash). Detected automatically; awaiting reviewer confirmation. | needs_review |
| 2020-01-01 | published | O-RADS US consensus guideline published. | 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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