A review of ovarian-adnexal reporting and data system and radiomics in ovarian cancer: focus on ultrasound applications.

Ovarian cancer (OC) is predominantly diagnosed at advanced stages, highlighting an urgent unmet need for effective early detection. The Ovarian-Adnexal Reporting and Data System (O-RADS) provides standardized criteria for ovarian ultrasound interpretation, and ultrasound based radiomics has evolved into a promising auxiliary modality for OC assessment. Cumulative evidence suggests that integrating radiomics features with O-RADS risk stratification can enhance non-invasive characterization of ovarian tumors, support diagnosis, and help evaluate treatment response. However, several critical barriers hinder its routine clinical implementation, including the lack of multicenter standardization, heterogeneous imaging protocols and poor cross-institutional reproducibility. This review systematically outlines the core diagnostic framework of O-RADS, summarizes recent advances in ultrasound radiomics, and explores the synergistic diagnostic performance of the combined workflow to guide clinical practice and future research endeavors.