To evaluate the stratification of patients with an adnexal mass into ovarian-adnexal reporting and data system (O-RADS) risk intervals based on ACR features and the IOTA two-step strategy. The IOTA two-step strategy classified 40% of all patients into O-RADS2 (0.9% prevalence of malignancy), 27% into O-RADS3 (4.4%), 14% into O-RADS4 (29.8%), and 19% into O-RADS5 (82%). The adnexal lesions underwent risk stratification into O-RADS categories using ACR features or the IOTA two-step strategy. [Extracted from the article]