OvarySim™

O-RADS US Risk Stratification · SonoAtlas

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Pick descriptors → watch the O-RADS category compute live.

Interactive ACR O-RADS US v2022 decision-tree simulator for adnexal masses. Toggle menopausal status, symptomatic flag, and optional IOTA Simple Rules comparison. Teaching mode reveals which branch of the decision tree fired and why. Free, open-access, no sign-up, works offline once loaded.

ACR O-RADS US v2022 IOTA Simple Rules optional 8 cases + 8-question quiz Shareable scenario URLs No sign-up · educational use
Menopausal
Symptoms
Pregnant?
Display mode
• Keyboard: R reset · C copy link · 1–5 jump to case type · Esc close dialog
• O-RADS US v2022 applies to women with adnexal lesions. Excludes known malignancy, surveillance of treated ovarian cancer, and pregnancy-specific lesions (use clinical judgment if pregnancy is flagged).
Step 1. What is the lesion? Pick one — the descriptors below will adapt

Teaching — decision path

Select descriptors to see which branch of the O-RADS tree fires.

Don't-miss mimics

Lesions that commonly get over- or under-called as the pattern you selected.

    Step 3. Case gallery — click a thumbnail to load descriptors 8 cases · Cat 1 → 5
    Step 4. Self-check quiz Score: 0 / 8

    Question 1 of 8

    Loading quiz…
    Step 5. Report snippet

    Radiology-style impression

    Select lesion descriptors above — the report will auto-generate here.
    O-RADS reference — category table, color score, size thresholds
    CatDescriptorMalignancy riskManagement
    1Normal ovaryn/aNo follow-up
    2Almost certainly benign< 1%Discharge or limited follow-up
    3Low risk1 – < 10%US 1 year (premeno) / MRI or specialist (postmeno)
    4Intermediate risk10 – < 50%MRI consideration + GynOnc consult
    5High risk≥ 50%GynOnc referral, usually surgical

    Size thresholds (simple cyst): pre-menopausal ≤ 3 cm = follicle, 3–10 cm = Cat 2, > 10 cm = Cat 3. Post-menopausal ≤ 3 cm = Cat 2, 3–10 cm = Cat 3, > 10 cm = Cat 4.

    IOTA color score: standardized color/power Doppler gain — 1 none, 2 minimal, 3 moderate, 4 strong.

    References

    1. Andreotti RF, et al. O-RADS US Risk Stratification and Management System: A Consensus Guideline from the ACR Ovarian-Adnexal Reporting and Data System Committee. Radiology. 2020;294(1):168-185. doi:10.1148/radiol.2019191150
    2. American College of Radiology. O-RADS US v2022 Lexicon & Risk Stratification Update. acr.org/O-RADS
    3. Timmerman D, et al. Simple ultrasound-based rules for the diagnosis of ovarian cancer. Ultrasound Obstet Gynecol. 2008;31(6):681-690.
    4. Van Calster B, et al. Evaluating the risk of ovarian cancer before surgery using the ADNEX model. BMJ. 2014;349:g5920.
    5. SRU Consensus. Management of asymptomatic ovarian and other adnexal cysts imaged at US. Radiology. 2010;256(3):943-954.
    OvarySim™ · SonoAtlas · Educational use only · Not a clinical decision tool · Back to SonoAtlas

    O-RADS US Category

    —
    < 1%10%50%≥ 50%
    Pick a lesion type above to start.
    Category, reasoning, management, and follow-up timeline will appear here.

    IOTA Simple Rules

    Pick M-features / B-features below the descriptors to see the IOTA verdict.

    What this means for you

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    O-RADS Decision Tree

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