Abstract:Objective To compare the diagnostic value of the International Ovarian Tumor Analysis (IOTA) Simple Rules and the Ovarian-Adnexal Reporting and Data System (O-RADS) in differentiating benign and malignant adnexal masses when applied by junior sonographers. Methods Retrospective analysis was performed on ultrasound imaging data from 116 patients with pathologically confirmed adnexal masses. Two junior sonographers independently evaluated the masses using three methods: conventional subjective ultrasound assessment, followed by the IOTA Simple Rules and O-RADS. Using pathological results as the gold standard, receiver operating characteristic (ROC) curves were plotted to compare the diagnostic performance of the three methods. Results A total of 144 masses were analyzed, including 123 benign and 21 malignant cases confirmed by pathology. The diagnostic accuracy rates for subjective assessment, IOTA Simple Rules, and O-RADS were 75.69%, 89.58%, and 86.81%, respectively; sensitivities were 76.19%, 95.24%, and 90.48%; specificities were 75.61%, 88.62%, and 86.18%; and AUC values were 0.76, 0.92, and 0.88. Statistical analysis revealed significant differences among the three methods (P<0.05). Conclusion Both the IOTA Simple Rules and O-RADS demonstrated superior diagnostic efficacy compared to subjective assessment when applied by junior sonographers. The IOTA Simple Rules exhibited higher sensitivity than O-RADS for detecting malignant adnexal masses and were more accessible for junior sonographers to master and apply.