O-RADS MRI: An updated meta-analysis of diagnostic performance, category-wise malignancy rates, and inter-observer reliability

Motivation: Ovarian-Adnexal Reporting and Data System (O-RADS) for magnetic resonance imaging (MRI) has been introduced into clinical practice. Studies have assessed its diagnostic performance, but inter-observer reliability has not been investigated. Goal(s): This study aims to update the systematic review of diagnostic performance, category-wise malignancy rates, and inter-observer reliability of O-RADS-MRI. Approach: We searched six electronic databases for studies on O-RADS-MRI that published from 2013 and 2024. The diagnostic performance, category-wise malignancy rates, and inter-observer reliability were pooled. Results: Twenty-nine studies were included. O-RADS-MRI presented high diagnostic performance (aera under curve 0.97, 0.95-0.98), and excellent inter-observer reliability (kappa 0.89). Impact: O-RADS-MRI presented high diagnostic performance with appropriate probability of malignant for each category, and excellent inter-observer reliability. The O-RADS-MRI can be an accurate and effective tool for ovarian-adnexal lesion assessment.