Unifying Concepts

Gynecologic Imaging Reporting and Data System (GI-RADS)

Transvaginal ultrasound is the main reference technique in the evaluation of adnexal masses. Based on the Breast Imaging Reporting and Data System (BIRADS) classification Amor et al. suggested adapting this system to gynecologic ultrasound for the evaluation of adnexal masses: Gynecologic Imaging Reporting and Data System (GI-RADS) and based on recognition patterns and criteria recommended by the IOTA group.

Gynecologic Imaging Reporting and Data System (GI-RADS)

GI-RADS grade


Probability of malignancy



Definitive benign


Normal ovaries identified and no adnexal mass seen


Very probably benign


Adnexal lesions thought to be of functional origin, e.g. follicles, corpora lutea, hemorrhagic cysts


Probably benign


Neoplastic adnexal lesions thought to be benign, such as endometrioma, teratoma, simple cyst, hydrosalpinx, paraovarian cyst, peritoneal pseudocyst, pedunculated myoma, or findings suggestive of pelvic inflammatory disease


Probably malignant


Any adnexal lesion not included in GI-RADS 1–3 and with one or two findings suggestive of malignancy*


Very probably malignant


Adnexal masses with three or more findings suggestive of malignancy*

* Thick papillary projections, thick septations, solid areas and/or ascites, defined according to International Ovarian Tumor Analysis (IOTA) criteria, and vascularization within solid areas, papillary projections or central area of a solid tumor on color or power Doppler assessment.



  1. Zhang T, Li F, Liu J, Zhang S. Diagnostic performance of the Gynecology Imaging Reporting and Data System for malignant adnexal masses. Int J Gynaecol Obstet. 2017 Jun;137(3):325-331. [Medline]
  2. Amor F, Alcázar JL, Vaccaro H, León M, Iturra A. GI-RADS reporting system for ultrasound evaluation of adnexal masses in clinical practice: a prospective multicenter study. Ultrasound Obstet Gynecol. 2011 Oct;38(4):450-5. [Medline]


Created Jan 03, 2018.

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