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© 2009 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 28:285-291 • 0278-4297

Gynecologic Imaging Reporting and Data System

A New Proposal for Classifying Adnexal Masses on the Basis of Sonographic Findings

Fernando Amor, MD, Humberto Vaccaro, MD, Juan Luis Alcázar, MD, Mauricio León, MD, José Manuel Craig, MD and Jaime Martinez, MD

Centro Ecografico Ultrasonic Panoramico, Santiago, Chile (F.A., H.V.); Department of Obstetrics and Gynecology, Clinica Universitaria de Navarra, University of Navarra, Pamplona, Spain (J.L.A.); Clinica Instituto de Diagnostico SA, Santiago, Chile (M.L., J.M.C.); and Clinica Davila, Santiago, Chile (J.M.).

Address correspondence to Juan Luis Alcázar, MD, Department of Obstetrics and Gynecology, Clinica Universitaria de Navarra, Avenida Pio XII 36, 31008 Pamplona, Spain. E-mail: jlalcazar{at}unav.es

Objective. The purpose of this study was to describe a new reporting system called the Gynecologic Imaging Reporting and Data System (GI-RADS) for reporting findings in adnexal masses based on transvaginal sonography. Methods. A total of 171 women (mean age, 39 years; range, 16–77 years) suspected of having an adnexal mass were evaluated by transvaginal sonography before treatment. Pattern recognition analysis and color Doppler blood flow location were used for determining the presumptive diagnosis. Then the GI-RADS was used, with the following classifications: GI-RADS 1, definitively benign; GI-RADS 2, very probably benign; GI-RADS 3, probably benign; GI-RADS 4, probably malignant; and GI-RADS 5, very probably malignant. Patients with GI-RADS 1 and 2 tumors were treated expectantly. All GI-RADS 3, 4, and 5 tumors were removed surgically, and a definitive histologic diagnosis was obtained. The GI-RADS classification was compared with final histologic diagnosis. Results. A total of 187 masses were evaluated. The prevalence rate for malignant tumors was 13.4%. Overall GI-RADS classification rates were as follows: GI-RADS 1, 4 cases (2.1%); GI-RADS 2, 52 cases (27.8%); GI-RADS 3, 90 cases (48.1%); GI-RADS 4, 13 cases (7%); and GI-RADS 5, 28 cases (15%). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 92%, 97%, 85%, 99%, and 96%, respectively. Conclusions. Our proposed reporting system showed good diagnostic performance. It is simple and could facilitate communication between sonographers/sonologists and clinicians.

Key Words: adnexal mass • reporting system • sonography

Abbreviations: GI-RADS, Gynecologic Imaging Reporting and Data System • NPV, negative predictive value • PPV, positive predictive value • RI, resistive index • TVS, transvaginal sonography

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Copyright © 2009 by the American Institute of Ultrasound in Medicine.