Evaluation of Risk Malignancy Index and Its Diagnostic Value in Patients with Ovarian Mass: A Prospective Study
Main Article Content
Introduction: Discrimination between benign and malignant ovarian tumors is essential before planning their management. Risk malignancy index is a combined parameter based on CA 125 level, USG score and menopausal status Aim: The objective is to examine the demographic characteristics of ovarian tumors and evaluate the effectiveness of the RMI 2 cutoff in distinguishing between malignant and benign ovarian tumors. Methods: A prospective study was carried out at two government hospitals in Chennai, namely the Institute of Obstetrics and Gynecology Hospital in Egmore and the ISO Kasthurba Gandhi Hospital. Patient records were used to obtain demographic profiles. RMI is computed based on CA 125, USG score, and menopausal status, and the study involved determining the sensitivity, specificity, positive predictive value, and negative predictive value of RMI 2 using different cut-off values. Results: The study compared RMI values at various cut-off points, and the findings indicated that using an RMI cut-off value of 200 provided higher accuracy in predicting malignancy, with a sensitivity of 84%, specificity of 95%, positive predictive value of 84%, and negative predictive value of 95.7%. Conclusion: In our study, we found that the ideal cut-off point for distinguishing between benign and malignant ovarian masses is 200. Therefore, RMI proved to be a useful tool for distinguishing between benign and malignant ovarian masses. RMI is simple easy to calculate and helps selection of patients for referral to tertiary center
Jacobs I, Oram D, Fairbanks J, Turner J, Frost C, Grudzinskas JG Br J Obstet
Gynaecol. 1990 Oct; 97(10):922-9.
The risk-of-malignancy index to evaluate potential ovarian cancers in local hospitals. Tingulstad S, Hagen B, Skjeldestad FE, Halvorsen T, Nustad K, Onsrud M Obstet Gynecol. 1999 Mar; 93(3):448-52.
Morgante G, Marca AI, Ditto A, et al. Comparison of two malignancy risk indices based on serum CA-125, ultrasound score and menopausal status in the diagnosis of ovarian masses. Br J Obstet Gynecol. 1999;1999(106):524–527. doi: 10.1111/j.1471-0528.1999.tb08318.x
Obeidat BR, Amarin ZO, Latimer JA, Crawford RA. Risk of malignancy index in the preoperative evaluation of pelvic masses. Int J Gynaecol Obstet. 2004;85(3):255–8
A.P. Manjunath, K. Sujatha, and R. Vani, “Comparison of three risk of malignancy indices in evaluation of pelvic masses,” Gynecologic Oncology, vol. 81, no. 2, pp. 225–229, 2001
Ulusoy et al The risk of malignancy index in discrimination of adnexal masses, International J GynaecolObstet 2007 Mar,96(3)
Sharadha, T.A. Sridevietal Ovarian masses changing clinicopathological trends J ObstetGynaecol India.2015 Feb ;65(1)34-38