scholarly journals Is Risk Malignancy Index a Useful Tool for Predicting Malignant Ovarian Masses in Developing Countries?

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Aliya B. Aziz ◽  
Nida Najmi
Keyword(s):  
Developing Countries ◽  
Likelihood Ratio ◽  
Menopausal Status ◽  
Tertiary Care ◽  
Positive Likelihood Ratio ◽  
Study Group ◽  
Adnexal Masses ◽  
Pelvic Masses ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index

Introduction. Risk of Malignancy Index (RMI) is widely studied for prediction of malignant pelvic masses in Western population. However, little is known regarding its implication in the developing countries. The objective of this study is to determine how accurately the RMI can predict the malignant pelvic masses.Materials and Methods. The study is a retrospective review of patients attending the gynecological clinic between January 2004 and December 2008 with adnexal masses. Information on demographic characteristics, ultrasound findings, menopausal status, CA125, and histopathology was collected. RMI score for each patient in the study group was calculated.Results. The study group included a total of 283 patients. Analysis of the individual parameters of RMI revealed that ultrasound was the best predictor of malignancy with a sensitivity, specificity, and positive likelihood ratio of 78.3%, 81.5%, and 4.2, respectively. At a standard cut-off value of 250, RMI had a positive likelihood ratio of 8.1, while it was 6.8 at a cut-off of 200, albeit with comparable sensitivity and specificity.Conclusion. RMI is a sensitive tool in predicting malignant adnexal masses. A cut-off of 200 may be suitable in developing countries for triaging and early referral to tertiary care centers.

scholarly journals Diagnostic accuracy of the risk of malignancy index 1 compared to the more recent IOTA ADNEX model in discriminating benign from malignant adnexal masses: a multi-centric study

2019 ◽  
Vol 8 (3) ◽  
pp. 1001
Author(s):  
Amita Ray ◽  
Divya S. ◽  
B. N. Kumar Guru ◽  
A. S. Ramaswamy ◽  
Bharat Kumar
Keyword(s):  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Predictive Value ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Adnexal Masses ◽  
Medical College ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index ◽  
Almost All

Background: Identification of the nature of an adnexal mass can ensure optimum management. Single parameters as well as diagnostic models using a combination of several parameters are in use. The International Ovarian Tumor Analysis (IOTA) consortium has developed and published the Assessment of Different NEoplasias in the adneXa (ADNEX) model, which differentiates between benign and malignant masses. Authors conducted this study with the aim of finding a cut off value for this model in the study population and comparing the diagnostic accuracy of this model to that of the risk of malignancy (RMI).Methods: Women with adnexal masses admitted to the 3 medical college affiliated hospitals for surgical management were included in this study. Appropriate investigations were done to calculate the RMI-I and ADNEX score for each participant. A cut off score for the ADNEX model was determined and diagnostic accuracy tests were done for comparison.Results: At a cut-off of 29 for the ADNEX model and 200 for RMI model the sensitivity was 75% and 77.8, specificity 100% and 80.6%; Positive Predictive Value (PPV) 100%and 60%; Negative Predictive Value (NPV) 91% and 90.6%; Positive Likelihood ratio of infinity and 4 and a negative Likelihood Ratio of 2.8 and 2.5 respectively.Conclusions: The ADNEX model rates higher than the RMI in almost all tests of diagnostic accuracy and can be used for triaging, framing a referral policy and prioritizing surgery.

scholarly journals Approach to Gynecological Adnexal Masses

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Laurie-Rose Dubé
Keyword(s):  
Reproductive Tract ◽  
Ovarian Neoplasm ◽  
Female Reproductive Tract ◽  
Reproductive Hormone ◽  
Adnexal Masses ◽  
Ultrasound Findings ◽  
Pelvic Masses ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index ◽  
Ovarian Abscess

Gynecological pelvic masses are a common occurrence in women of all ages. The differential diagnosis is extensive and includes masses of all anatomical components of the female reproductive tract. This simple and refined approach leads the reader through the process of narrowing said differential. A thorough history and physical examination are essential steps that can hint to the appropriate investigations such as reproductive hormone levels, serum cancer biomarkers and imaging. Emphasis is put on ultrasound findings, helping differentiate not only diagnoses, but also the benign or malignant character of the mass. It also highlights the Risk of Malignancy Index I, commonly used in clinical practice to assess the risk of malignancy of a mass. Beyond the initial approach, some diagnoses and their management are discussed, from the very common functional cyst to the worrisome ovarian neoplasm, and mentioning more peculiar findings like tubo-ovarian abscess and leiomyoma.

scholarly journals Efficacy of HE4, CA125, Risk of Malignancy Index and Risk of Ovarian Malignancy Index to Detect Ovarian Cancer in Women with Presumed Benign Ovarian Tumours: A Prospective, Multicentre Trial

2019 ◽  
Vol 8 (11) ◽  
pp. 1784 ◽  
Author(s):  
Vincent Dochez ◽  
Mélanie Randet ◽  
Céline Renaudeau ◽  
Jérôme Dimet ◽  
Aurélie Le Thuaut ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Likelihood Ratio ◽  
Positive Likelihood Ratio ◽  
Ovarian Malignancy ◽  
Cancer Antigen 125 ◽  
Mean Values ◽  
Benign Ovarian Tumours ◽  
Ovarian Tumours ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index

Background: Presumed benign ovarian tumours (PBOT) are defined by the International Ovarian Tumour Analysis (IOTA) group, without suspected sonographic criteria of cancer, without ascites or metastasis. The aim is to evaluate the efficacy of human epididymis protein 4 (HE4), cancer antigen 125 (CA125), the risk of malignancy index (RMI) and the risk of ovarian malignancy index (ROMA) to predict ovarian cancer in women with PBOT. Methods: It is a prospective, observational, multicentre, laboratory-based study including women with PBOT in four hospitals from 11 May 2015 through 12 May 2016. Preoperative CA125 and HE4 plasma levels were measured for all women. The primary endpoint was the specificity of CA125 and HE4 for diagnosing ovarian cancer. The main secondary endpoints were specificity and likelihood ratio of RMI, ROMA and tumours markers. Results: Two hundred and fifty patients were initially enrolled and 221 patients were finally analysed, including 209 benign ovarian tumours (94.6%) and 12 malignant ovarian tumours (5.4%). The malignant group had significantly higher mean values of HE4, CA125, RMI and ROMA compared to the benign group (p < 0.001). Specificity was significantly higher using a combination of HE4 and CA125 (99.5%) compared to either HE4 or CA125 alone (90.4% and 91.4%, respectively, p < 0.001). Moreover, the positive likelihood ratio for combination HE4 and CA125 was significantly higher (104.5; 95% CI 13.6–800.0) compared to HE4 alone (5.81; 95% CI 2.83–11.90) or CA125 alone (6.97; 95% CI 3.91–12.41). Conclusions: The combination of HE4 and CA125 represents the best tool to predict the risk of ovarian cancer in patients with a PBOT.

scholarly journals Evaluation of the risk malignancy index diagnostic value in patients with adnexal masses

2011 ◽  
Vol 68 (7) ◽  
pp. 589-593 ◽  
Author(s):  
Milan Terzic ◽  
Jelena Dotlic ◽  
Ivana Likic-Ladjevic ◽  
Jasmina Atanackovic ◽  
Nebojsa Ladjevic
Keyword(s):  
Predictive Value ◽  
Menopausal Status ◽  
Diagnostic Value ◽  
Gynecologic Malignancies ◽  
Adnexal Masses ◽  
Average Value ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index ◽  
Practice Methods ◽  
Sensitivity Specificity

Background/Aim. Ovarian cancer is the leading cause of death from gynecologic malignancies. Risk of malignancy index (RMI) is recommended in assessment of patients with adnexal masses. The aim of this study was to verify the effectiveness of the RMI in the discrimination between benign lesions and malignant adnexal masses in clinical practice. Methods. Ultrasounds were performed for all the patients and menopausal status, CA125 level and calculated RMI were defined. All the patients were divided into 3 groups depending on RMI (< 25, 25-200, > 200). After operations all adnexal masses were analyzed histopathologically (HP) and then sensitivity, specificity and predictive value of RMI were calculated. Results. Out of a total of 81 patients involved benign tumor had 51 (62.96%) and malignant 30 (37.04%) of the patients. The average value of CA125 in the group of patients with benign adnexal masses was 68.3 U/mL and in the group of patients with malignant adnexal masses it was 581.95 U/mL. In the group of patients with benign adnexal masses the average RMI was 284.9 and in the group of patients with malignant adnexal masses RMI was 469.2. All the results showed a positive correlation between both HP categories and RMI categories. The more malignant HP result produced higher RMI and the cut off value was RMI = 200. Sensitivity of RMI was 83.33%, specificity was 94.12%, positive predictive value was 89.29% and negative predictive value was 90.57%. Conclusion. Our study showed that RMI is very reliable in differentiation benign from malignant adnexal masses.

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 The accuracy of modified risk malignancy index (RMI) in predicting malignancy of epithelial type ovarian cancer

2019 ◽  
pp. 228-232
Author(s):  
Esfi Triana ◽  
Defrin Dr. ◽  
Joserizal Serudji ◽  
Adriswan Dr.
Keyword(s):  
Likelihood Ratio ◽  
Predictive Value ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Ovarian Tumour ◽  
Scoring Method ◽  
Chi Square ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index ◽  
Sensitivity Specificity

Abstract Objective:To investigate the accuracy of modified Risk of Malignancy Index (RMI) in predicting malignancy of epithelial type ovarian tumour. Method: This research was comparative research using cross-sectional study design, which compared RMI modification and RMI method in predicting malignancy of epithelial type ovarian tumour. The sampling technique was consecutive sampling. This research was conducted on October 2017 until samples were fulfilled in Obstetrics and Gynecology Division of RSUP Dr. M. Djamil and Laboratory of RSUP Dr. M Djamil in Padang. Chi-square test was used to compare specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), negative likelihood ratio (NLR, and accuracy of RMI modification and RMI with 95% CI (p≤0,05). Results: A total of 61 subjects were recruited in this study. Sensitivity, specificity, PPV, NPV, PLR, NLR, and accuracy RMI modification scoring was 90.5%, 82.5%, 73.1%, 94.3%, 5.1, 0.1, dan 85.2%. Sensitivity, specificity, PPV, NPV, PLR, NLR, and accuracy RMI scoring was 66.7%, 70%, 53.8%, 80%, 2.2, 0.4, and 70% Conclusions:Modified RMI scoring method was more accurate in predicting the malignancy of ovarian type epithelial tumours than RMI. Keywords: CA125, malignancy, ovarian tumor,pelvic mass, RMI,   Abstrak Tujuan: Mengetahui akurasi Risk of Malignancy Index (RMI) dalam prediksi keganasan tumor ovarium tipe epitel.  Metode: Penelitian ini merupakan penelitian komparatif dengan desain penelitian potong lintang yang membandingkan metode RMI modifikasi dan RMI dalam prediksi keganasan tumor ovarium tipe epitel. Jumlah sampel sebanyak 61 orang. Teknik pengambilan sampel berurutan. Penelitian di mulai pada bulan Oktober 2017 hingga jumlah sampel terpenuhi di Departemen Obstetri dan Ginekologi RSUP Dr. M Djamil dan Laboratorium RSUP Dr. M Djamil Padang. Untuk membandingkan spesifisitas, sensitivitas, nilai duga positif (NDP), nilai duga negatif (NDN), rasio kemungkinan positif (RKP), rasio kemungkinan negatif (RKN), dan akurasi RMI modifikasi dan RMI digunakan uji chi-square dengan 99% CI (p≤0,01). Hasil: Sensitivitas, spesifisitas, NDP, NDN, RKP, RKN, dan akurasi skoring RMI modifikasi adalah 90,5%, 82,5%, 73,1%, 94,3%, 5,1, 0,1, dan 85,2%. Sensitivitas, spesifisitas, NDP, NDN, RKP, RKN, dan akurasi skoring RMI adalah 66,7%, 70%, 53,8%, 80%, 2,2, 0,4, dan 70%. Kesimpulan: Metode skoring RMI modifikasi lebih akurat dalam memprediksi keganasan tumor ovarium tipe epitel dibandingkan RMI. Kata kunci: CA125, keganasan, massapelvik, RMI, tumor ovarium

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 Comparison of ovarian crescent sign and risk of malignancy index for prediction of ovarian malignancy in adnexal masses

2021 ◽  
Vol 10 (2) ◽  
pp. 541
Author(s):  
Abha Sharma ◽  
Richa Sharma ◽  
Ashita Gulati
Keyword(s):  
Negative Predictive Value ◽  
Predictive Value ◽  
Early Stage ◽  
Menopausal Status ◽  
Ovarian Malignancy ◽  
Adnexal Masses ◽  
Crescent Sign ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index ◽  
Mass Size

Background: Objective of the study was to evaluate ovarian crescent sign (OCS) as a sonographic parameter for prediction of ovarian cancer in adnexal masses suspicious of ovarian malignancy and to compare it with risk of malignancy index (RMI).Methods: Presence of OCS and calculation of RMI was done for 50 cases of adnexal masses scheduled to undergo surgery taking histopathology as gold standard.Results: 18% (9/50) of adnexal masses were malignant. OCS was absent in all malignant lesions, giving a sensitivity and negative predictive value of 100%. OCS was present in 33/41 of benign masses (specificity 80.4%). Relation of OCS to mass size<10 cm and menopausal status was significant (p<0.001). RMI≥200 could not diagnose malignancy in 4/9 cases (sensitivity 55.5%). RMI had specificity and negative predictive value of 95.1% and 90.7% respectively. Combining OCS and RMI had a lower specificity. Sequential application using OCS as first node and RMI as second node failed to diagnose 44.4% (4/9) cases as malignant.Conclusions: OCS is cheaper, easy to perform and appears to be a better test than RMI to differentiate between benign and early-stage malignant ovarian tumors. It can be used for triaging patient for referral.

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