The New Indian Journal of OBGYN. 11(2):313-319

Evaluation of adnexal masses using risk of malignancy index 3 (RMI 3)

Rama Garg, Parneet Kaur

ABSTRACT

Objectives: No ideal screening test is available for ovarian cancer. The Risk of Malignancy Index (RMI) can be an important tool for preoperative triaging of adnexal masses for appropriate management. Aim: To assess the sensitivity and specificity, positive predictive value (PPV), and negative predictive value (NPV) of RMI 3 for evaluation of adnexal masses. Methods: A prospective observational study was conducted on 60 women with an adnexal mass referred to a tertiary care institute in North India and managed surgically. Data on demographic characteristics, menopausal status, ultrasound findings, serum CA125, and histopathology were collected. RMI 3 was calculated in all women and correlated with the intraoperative findings and histopathology. Results: RMI 3 at a cut-off of >200 had sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 56%, 93%, 63%, and 91% respectively in diagnosing ovarian malignancy. RMI was more accurate than CA125 alone in diagnosing malignant from benign masses. Conclusion: RMI is a sensitive, less expensive, reproducible tool available even in low-resource settings with good sensitivity, specificity, PPV, and NPV in diagnosing ovarian malignancy. A cut-off of 200 may be suitable for triaging and early referral to tertiary care centers.