Risk of malignancy index (RMI) for prediction of malignancy in women with adnexal masses

Abstract

Ovarian cancer is predominantly cancer in the perimenopausal and post- menopausal age group. A definitive biomarker has not been identified for malignant ovarian cancer and histopathology remains the diagnostic gold standard for this. Risk of Malignancy Index (RMI) in predicting malignant pelvic masses includes serum CA125 level, menopausal status, and ultrasonographic findings. The risk of malignancy index (RMI) was evaluated in the women presented with adnexal masses for its accuracy in predicting the malignancy. This was a retrospective study which included 120 women who presented with adnexal mass in a tertiary hospital. RMI scoring was done based on CA125 levels, ultrasound findings and postmenopausal status and RMI was correlated with the histopathological findings. Out of 120 subjects, 74.1% of subjects were proved to have malignant tumors. RMI in predicting malignancy showed a sensitivity of 88.76%, a specificity of 45.37%, a positive predictive value of 81.63%, a negative predictive value of 66.67% and an accuracy of RMI found to be 82.5%. The RMI is found to be a simple, cost-effective and reliable tool in predicting malignancy in women presenting with adnexal masses that helps in timely referral to a gynaecological oncology center for better management and survival. RMI scoring can be used as it is a better tool for analysing multiple parameters of the tumour.