Diagnostic accuracy of the O-Rads and Adnex models in identifying malignant adnexal lesions taking histopathology as gold standard.

Objective: To use histopathology as the gold standard to assess the diagnostic accuracy of the O-RADS and ADNEX models in identifying malignant adnexal lesions. Study Design: Cross Sectional (validation) Study. Setting: Aziz Fatima Medical and Dental College Faisalabad, Faisalabad Medical University, Faisalabad. Period: 01-01-2025 to 30-06-2025. Methods: Included were 170 patients aged 20–60 who were admitted for elective surgical ovarian mass exploration and excision. An oophorectomy history, a history of adnexal malignancy, a history of adnexal mass surgery, pregnancy or ectopic pregnancy, and failure to have surgery within 120 days of the ultrasound screening were all disqualified. Five milliliters of venous blood were sent to the pathology lab for the measurement of serum CA-125 levels. Senior radiologist performed the ultrasound, noting O-RADS and ADNEX model properties. The advanced gynecologist performed the surgery. On O-RADS, ADNEX model, and histology, a malignant adnexal lesion was observed. Results: In terms of identifying malignant adnexal lesions using histopathology as the gold standard, O-RADS's overall sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were 90.53%, 85.33%, 88.66%, 87.67%, and 88.24%, respectively. When employing histopathology as the gold standard to identify malignant adnexal lesions, the ADNEX model's overall sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were 86.17%, 81.57%, 85.26%, 82.67%, and 84.12%, respectively. Conclusion: This study found that the diagnostic accuracy of the O-RADS and ADNEX models for identifying malignant adnexal lesions is nearly equal.