The Gynaecologic Imaging-Reporting and Data System (GI-RADS) is a reporting system that was created for reporting the findings in adnexal masses based on transvaginal ultrasonography.
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Classification
Findings are classified into five categories 1:
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GI-RADS 1
normal ovaries identified and no adnexal mass seen
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GI-RADS 2
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adnexal functional lesions
follicles
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GI-RADS 3
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benign neoplastic adnexal lesions
pedunculated myoma
changes suggestive of pelvic inflammatory disease
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GI-RADS 4
any adnexal lesion not included in GI‐RADS 1–3
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in addition, the lesion has one or two findings suggestive of malignancy such as
thick papillary projections
thick septationsd
solid areas
vascularisation within solid areas
papillary projections
a central area of a solid tumour visualised on colour or power Doppler
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GI-RADS 5
adnexal masses with three or more findings suggestive of malignancy (as listed above)
Treatment and prognosis
GI-RADS has shown good performance 2 with a 2021 meta-analysis 3 reporting a sensitivity of 95% and specificity of 86% at diagnosing malignant tumours from adnexal masses.
Risk of malignancy has been reported as 1:
GI-RADS 1: 0%
GI-RADS 2: <1%
GI-RADS 3: 1-4%
GI-RADS 4: 5-20%
GI-RADS 5: >20%
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