O-RADS US validated in pediatric adnexal lesions, simplified C-CAS framework proposed

Retrospective study validates O-RADS US for pediatric adnexal lesions (AUC 0.93); simplified C-CAS (Cysts-Color-Ascites-Shadowing) framework maintained accuracy in external validation (AUC 0.95).

• Retrospective diagnostic accuracy study of 396 pediatric adnexal lesions (44 malignant) from four centers, with external validation.
• At O-RADS ≥4 cutoff: sensitivity 97.2%, specificity 89.1%, NPV 99.6%.
• Simplified C-CAS framework had external validation AUC 0.948; limited by retrospective design and small number of malignancies.

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