Gynaecological Pelvic Ultrasound

What it does

Gynaecological Pelvic Ultrasound reads transvaginal (TVS) and transabdominal (TAS) pelvic studies done for pelvic pain, abnormal bleeding, an adnexal mass or infertility. Upload the stills and cine of the uterus and both adnexa together with the patient's menopausal status and cycle day; O-RADS and the endometrial thresholds depend on them.

The result covers the uterus (size, a fibroid map by FIGO type, adenomyosis features), the endometrium (thickness, pattern, focal lesions), both ovaries with their follicles, and every adnexal lesion described in the IOTA and O-RADS lexicon with an O-RADS US category from 0 to 5 and its management.

Intended use

Decision support for gynaecologists who scan and read their own patients, and for radiologists reporting pelvic ultrasound. Physiological cysts and neoplasms can look alike and colour scoring is subjective, so each O-RADS category shows the descriptors and colour score that produced it.

Who it is for

Gynaecologists, reproductive-medicine and IVF specialists, gynaecological oncologists, radiologists and sonographers. Developers use the run to pre-fill O-RADS fields, follicle-monitoring charts and fertility-clinic records.

Accepted input

• Pelvic studies: DICOM Ultrasound Image and Multi-frame objects, transvaginal or transabdominal, grey-scale and colour or power Doppler.
• Ovarian sweeps: cine through each ovary for follicle counting.
• Vendor measurements: OB-GYN SR objects (TID 5000) are read as a second source.

Requirements

Requirement	Why
Menopausal status	O-RADS categories and endometrial thickness thresholds differ before and after menopause
Cycle day or LMP	Endometrial appearance and follicle size change through the cycle
Sagittal uterus through the endometrium	Double-layer endometrial thickness is measured there
Sweep through each ovary	Follicles are counted and measured across the whole ovary, not on one image
Colour or power Doppler of solid components	Part of the O-RADS lexicon
SequenceOfUltrasoundRegions calibration	Lesion, fibroid, endometrium and follicle sizes in millimetres

Optional context

Age and the clinical question (pain, bleeding, known mass, IVF monitoring) go in clinical_context.

The result

One JSON result in sections with findings, measurements and classifications; menopausal status is stored in the result so each category can be traced to the rule that applied. Each lesion keeps a lesion_id and side.

Section	Content
Uterus and fibroids	Uterine size, fibroid map with FIGO type, size and location, adenomyosis features
Endometrium	Double-layer thickness, pattern and focal lesions in IETA terms
Adnexal masses (O-RADS)	IOTA and O-RADS lexicon descriptors, O-RADS US category 0–5 and the management it carries
Follicles	Follicle count and diameters for IVF monitoring, antral follicle count and polycystic ovarian morphology
Draft report	Opt-in (options.report): an English narrative that interprets the result for the reader (findings, impression, limitations); every number is checked against the findings

Standards

• Adnexa: O-RADS US v2022 risk stratification and management; IOTA terms for lesion description.
• Uterus: MUSA consensus for myometrial and adenomyosis features; FIGO leiomyoma classification for fibroid type.
• Endometrium: IETA consensus terms.
• Ovaries: 2023 International PCOS guideline for polycystic ovarian morphology.
• DICOM: SR OB-GYN Ultrasound Procedure Report TID 5000 with its gynaecology sections; SEG for lesion masks; GSPS calipers; Encapsulated PDF.
• Terminology: RadElement common data elements for O-RADS.

Scoring notes

The O-RADS US category for each lesion comes from its descriptors and the menopausal status, and the result keeps both, so a reader can see which descriptor set the category. O-RADS 0 is an incomplete evaluation; 1 is a normal premenopausal ovary with physiological follicles or a corpus luteum; 2 is almost certainly benign; 3 is low risk; 4 is intermediate risk; 5 is high risk. Each category carries its O-RADS management, from no follow-up to referral to a gynaecological oncologist.

Related models

• us/obstetric reads early pregnancy, including signs of ectopic pregnancy.