A risk of malignancy index incorporating CA 125, ultrasound and menopausal status for the accurate preoperative diagnosis of ovarian cancer

1990 ◽  
Vol 97 (10) ◽  
pp. 922-929 ◽  
Author(s):  
I. JACOBS ◽  
D. ORAM ◽  
J. FAIRBANKS ◽  
J. TURNER ◽  
C. FROST ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Preoperative Diagnosis ◽  
Menopausal Status ◽  
Ca 125 ◽  
Accurate Preoperative Diagnosis ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index

scholarly journals Risk of Malignancy Index is not accurate as a Triage Tool for Ovarian Cancer

2014 ◽  
pp. 50-54
Author(s):  
Gregorius Tanamas ◽  
Jasmine Iskandar ◽  
Tofan W Utami ◽  
Tricia D Anggraeni ◽  
Kartiwa H Nuryanto
Keyword(s):  
Ovarian Cancer ◽  
Menopausal Status ◽  
Ca 125 ◽  
Normal Body Mass Index ◽  
Ovarian Cancer Risk ◽  
Malignant Case ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index ◽  
Pathological Report ◽  
Ovarian Masses

Objective: To evaluate Risk of Malignancy Index (RMI) as a triage tool for ovarian cancer in Dr. Cipto Mangunkusumo Hospital. Method: This is a retrospective study conducted from January 2008-December 2012 in patients diagnosed with ovarian mass. Patients admitted for surgery due to ovarian masses were included to this study. RMI 3 score was calculated based on ultrasonography examination in Dr. Cipto Mangunkusumo Hospital, CA-125 test and menopausal status. Patients without final pathological report and incomplete data were excluded from study. Data were analysed using SPSS 20 to evaluate RMI result and final pathlogical report in benign and malignant case. Result: From 882 patients identified with ovarian masses from cancer registry, only 99 patients aged 17-70 y.o were included in this study. Most of the patients were nully-parity (28.3%), non-menopausal women (60.6%), normal body mass index (40.4%), and with stage IIIC ovarian cancer (33.3%). Ultrasonography examination showed that most of patients had solid mass and ascites (19.2%). Meanwhile, CA-125 showed that patients with <35 U/ml were 10.1% and ≥ 35 U/ml were 89.9%. Patients with RMI scores <200 (benign cases) were 19 cases (19.2%) and ≥ 200 (malignant cases) were 80 cases (80.8%). Meanwhile, patients with benign final pathological report were 23 cases (23.2%) and malignant cases were 76 cases (76.8%). There was no statistical difference in RMI between benign and malignant cases based on final pathological report. Conclusion: Our study showed that RMI was not accurate as triage tool for ovarian cancer in our hospital. Further investigation and more patients are needed to confirm this study. Keywords: CA-125, menopausal status, ovarian cancer, risk of malignancy index (RMI), ultrasonography.

The Risk of Malignancy Index for Ovarian Tumours in Northeast Scotland – a Population Based Study

2009 ◽  
Vol 54 (2) ◽  
pp. 21-23 ◽  
Author(s):  
VN Harry ◽  
GV Narayansingh ◽  
DE Parkin
Keyword(s):  
Malignant Disease ◽  
Imaging Techniques ◽  
Menopausal Status ◽  
Population Based ◽  
Ca 125 ◽  
Royal Infirmary ◽  
Ovarian Tumours ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index ◽  
Ovarian Pathology

Background and Aims The Scottish Intercollegiate Guidelines Network (SIGN) recommends the use of the Risk of Malignancy Index (RMI) for ovarian tumours, a scoring system based on ultrasound findings, menopausal status and CA 125 level, in the pre-operative evaluation of pelvic masses. The aim of this study was to investigate the accuracy of this as a predictive method of discriminating benign from malignant disease. Methods and Results All women who underwent oophorectomy in 2004 at Aberdeen Royal Infirmary for suspected primary ovarian pathology were evaluated. The RMI was calculated and these results were compared with the final histopathology. The sensitivity of the RMI for diagnosing malignant ovarian disease was 94% (32/34) while the specificity was 70% (76/108). Conclusions Compared to previous studies, the RMI score was highly sensitive in detecting malignant disease, although not as specific in excluding benign lesions, particularly cystadenomas and endometriomas. This can be improved by the refinement of imaging techniques as well as the use of laparoscopy in particular cases. The RMI score may also be especially valuable in directing referrals to a specialised centre.

scholarly journals Risk-of-Malignancy Index in preoperative evaluation of clinically restricted ovarian cancer

2002 ◽  
Vol 120 (3) ◽  
pp. 72-76 ◽  
Author(s):  
José Carlos Campos Torres ◽  
Sophie Françoise Mauricette Derchain ◽  
Aníbal Faúndes ◽  
Renata Clementino Gontijo ◽  
Edson Zangiacomi Martinez ◽  
...  
Keyword(s):  
Menopausal Status ◽  
Serum Levels ◽  
Individual Performance ◽  
Diagnostic Methods ◽  
Ca 125 ◽  
Ovarian Carcinomas ◽  
Pelvic Masses ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index ◽  
Ultrasound Score

CONTEXT: There is no adequate preoperative method for differentiating between benign and malignant pelvic masses. Evaluations of CA 125 serum levels, ultrasonography findings and menstrual state have been tested in isolation as diagnostic methods. The evaluation of these three methods in association with each other could improve diagnostic performance. OBJECTIVE: To evaluate the risk-of-malignancy index by combining serum CA 125 levels, ultrasound score and menopausal status in preoperative diagnoses for women with pelvic masses clinically restricted to the ovaries and without clear evidence of malignancy. DESIGN: Cross-sectional study. SETTING: Centro de Atenção Integral à Saúde da Mulher, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil. PARTICIPANTS: 158 women admitted between January 1996 and March 1998 for surgical exploration of pelvic masses. PROCEDURES: The risk-of-malignancy index was calculated as US x M x CA 125, performed preoperatively. Ultrasound findings were classified according to the shape, size, multiplicity, presence of wall expansion involvement or ascites, using a score system (US). Menopausal status was considered as 1 for premenopausal and 3 for postmenopausal (M), and CA 125 serum levels were considered in absolute values. STATISTICAL ANALYSIS: Most relevant variables were included in a logistic multiple regression model, fitted using the ultrasound score, the serum CA 125 level and the menopausal status. The model was used for evaluating the performance of each individual predictor in determining the malignancy of these tumors and identifying the risk-of-malignancy index. RESULTS: The best individual performance was found in CA 125 levels (sensitivity of 78%, specificity of 75%), followed by ultrasound score (sensitivity of 75%, specificity of 73%) and menopausal status (sensitivity of 73%, specificity of 69%). The performance obtained for the risk-of-malignancy index at the cut-off point of 150 was a sensitivity and specificity of 79%. The area under the ROC curve for the risk-of-malignancy index was 0.90, which was greater than the area for CA 125 levels (0.83) or ultrasound score (0.79). CONCLUSION: The risk-of-malignancy index using ultrasound morphological score, serum CA 125 levels and menopausal status might be of value in the preoperative assessment of ovarian carcinomas.

scholarly journals Validity of Cancer Antigen-125 (CA-125) and Risk of Malignancy Index (RMI) in the Diagnosis of Ovarian Cancer

2015 ◽  
Vol 30 (6) ◽  
pp. 428-434 ◽  
Author(s):  
Khawla Al-Musalhi ◽  
Manal Al-Kindi ◽  
Fatma Ramadhan ◽  
Thuraya Al-Rawahi ◽  
Khalsa Al-Hatali ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Ca 125 ◽  
Cancer Antigen 125 ◽  
Cancer Antigen ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index

scholarly journals ONCOGYNECOLOGICAL ASPECTS ОF ADNEXAL MASSES

2013 ◽  
Vol 68 (8) ◽  
pp. 9-13 ◽  
Author(s):  
A. S. Gasparov ◽  
K. I. Zhordania ◽  
Yu. G. Payanidi ◽  
E. D. Dubinskaya
Keyword(s):  
Malignant Tumors ◽  
Menopausal Status ◽  
Pelvic Mass ◽  
Serous Cystadenoma ◽  
Ca 125 ◽  
Adnexal Masses ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index ◽  
Benign Ovarian Tumors ◽  
Reproductive Aged Women

Adnexal masses are frequently found in both symptomatic and asymptomatic women. The frequency of them is 7,8% in reproductive aged women and 2,5–18% in postmenopausal patients. Aim: to investigate clinical significance of the Risk of Malignancy Index (RMI) and to compare it with histological findings in patients with adnexal masses. Patients and methods: 345 patients with adnexal masses were evaluated. Depending on the menopausal status, serum CA-125 level and ultrasonographic findings RMI scores were calculated for each of patients. Results: according to RMI all the patients were divided in to two groups: first group — 283 (62%) of patients with RMI less then 200 and the second group — 52 (38%) women with RMI more then 200. The patients of the second group were referred to the oncologist. Among the patients with RMI 200, 137 (48,4%) endometriomas, 73 (25,8%) serous cystadenoma, 45 (15,9%) dermoid cysts, 22 (7,8%) paraovarian cysts, 2 (0,7%) adenocarcinoma were detected after histological examination. In patients with RMI 200, 25% of benign ovarian tumors, 34,6% of borderline and 40,4% of malignant tumors were verified. Conclusions: RMI when used in the presence of a pelvic mass is a useful triage tool to determine those women who should be referred to a gynaecological oncologist. During laparoscopy, in cases of intraoperative malignancy suspicion staging should be performed: videorecord of the surgery, biopsy of the adnexal mass and contralateral ovary, biopsy of the omentum and peritoneum, and aspiration of the peritoneal fluid for cytological examination.

scholarly journals Risk of malignancy index 4 in preoperative evaluation of patients with ovarian tumours

2018 ◽  
Vol 7 (6) ◽  
pp. 2467
Author(s):  
Sunita Singhal ◽  
Lata Rajoria ◽  
Premlata Mital ◽  
Alka Batar ◽  
Richa Ainani ◽  
...  
Keyword(s):  
Predictive Value ◽  
Ovarian Tumor ◽  
Preoperative Evaluation ◽  
Menopausal Status ◽  
Ovarian Tumour ◽  
Ca 125 ◽  
Benign Ovarian Tumor ◽  
Ovarian Tumours ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index

Background: Ovarian tumors usually presents as adnexal masses which may be benign or malignant. Accurate and timely diagnosis of an adnexal mass is a challenge for the gynecologists. Currently clinical examination, ultrasonographic assessment and ovarian tumour markers (CA 125, beta hCG, AFP, LDH) are routinely done at our centre to evaluate patients with ovarian tumours. The study was designed to evaluate the ability of RMI 4 to discriminate benign ovarian tumor from malignant ovarian tumor in patients attending Department of Obstetrics and Gynaecology, S.M.S. Medical College, Jaipur.Methods: 200 patients diagnosed to have ovarian tumours were included in the study after obtaining written consent. Ultrasonographic characteristic, menopausal status and serum CA 125 levels were documented preoperatively. Risk of malignancy index 4 was calculated and correlated with histopathological diagnosis.Results: At a cut-off point of 450, RMI 4 had a sensitivity of 67.5% (95% CI: 50.87-81.43%), specificity of 98.75% (95.56-99.85%), positive likelyhood ratio of 54, negative likelyhood ratio of 0.33, a positive predictive value of 93.1%, negative predictive value of 92.4% and diagnostic accuracy of 92.5%.Conclusions: RMI 4 is a simple, cost effective, reliable scoring system that is easily applicable method in primary evaluation of patients with ovarian tumours with a sensitivity of 67.5% and specificity of 98.75%.

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