Differential diagnosis of adnexal masses, especially those of ovarian origin, may be a challenge clinically and radiologically. Inconsistency while describing morphology of the lesion often results in significant differences in subsequent interpretations. The use of internationally agreed upon standardized systems help reduce inter observer variability in reports, thus increasing the probability of a correct diagnosis. Various prediction models have been developed to assist clinicians to determine the risk of malignancies in adnexal masses. This helps deciding the appropriate treatment strategy suited for the patient. Risk of Malignancy Index (RMI) was the first of such systems. Subsequently, other scoring systems including IOTA SR, IOTA LR, O-RADS, GI-RADS and most recently, the IOTA ADNEX score have been introduced. 

The available radiological scoring systems were established and tested based on data obtained from European populations. These systems need to be more widely validated in practice with various ethnic populations. Our study aims to compare the diagnostic efficacy of the O-RADS, IOTA SR, IOTA ADNEX rules for predicting benign and malignant ovarian tumours in the Indian population.