“…For this reason, scoring systems and logistic models, such as the Risk of Malignancy index, IOTA simple rules, Risk Assessment based on Simple rules, LR1 model, LR2 model, ADNEX model, GI-RADS and O-RADS classification systems were developed in an attempt to overcome this limitation [21,22,[50][51][52][53][54]. No doubt, these approaches have produced a significant advance in the ultrasound discrimination of adnexal masses, allowing lessexperienced examiners achieve good results in terms of diagnostic performance [55][56][57][58][59][60][61][62][63]. However, the expert examiner is still the most cost-effective approach [49].…”