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 Pre-operative Assessment of Ovarian Tumor in Patients Presenting with Adnexal Mass on the Basis of Risk of Malignancy Index (RMI)

2018 ◽  
Vol 9 (2) ◽  
pp. 69-73
Author(s):  
Sanjukta Chowdhury ◽  
Raunak Jahan ◽  
Dina Layla Hossain ◽  
Fahmida Sharmin Joty ◽  
Sumana Rahman ◽  
...  
Keyword(s):  
Predictive Value ◽  
Adnexal Mass ◽  
Malignant Tumors ◽  
Menopausal Status ◽  
Ca 125 ◽  
Cross Sectional ◽  
Gynaecologic Cancer ◽  
Ultrasound Findings ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index

Background:Ovarian cancer is the second most common gynaecologic cancer in developing countries. Five-year survival of ovarian cancer varies according to stages, hence, screening, detection and treatment in earlier stages are of great importance. The Scottish Intercollegiate Guidelines Network (SIGN) recommends use of Risk of Malignancy Index (RMI) for preoperative assessment of ovarian tumours. It is a scoring system based on menopausal status, ultrasound findings, and serum CA 125 level in adnexal mass.Objective:To investigate the accuracy of RMI as a predictive method of discriminating benign from malignant ovarian tumour.Methodology: Fifty patients, 30 years or older, with adnexal mass, admitted for laparotomy in Obstetrics and Gynaecology Dept. from April’13 to September’13were randomly assigned in this cross-sectional descriptive study. RMI was calculated for each patient based on menopausal status, CA125 level and ultrasound findings of bilateral lesion, multilocular cyst, solid areas, ascites and metastases.Results:Among 50 women, 18 cases (36%) were postmenopausal showing more malignant tumors (77.78%) in this group. Depending on histopathological reports, 82% benign and 18% malignant diseases.The best performance of RMI was obtained at cut-off value of 230 with sensitivity of 100%, specificity of 95.2%, positive predictive value (PPV) of 80% and negative predictive value (NPV) 100%. Conclusion:Compared to previous studies, RMI was highly sensitive in detecting malignant disease, though not as specific in excluding benign lesions, particularly endometriosis.J Shaheed Suhrawardy Med Coll, December 2017, Vol.9(2); 69-73

scholarly journals Role of human epididymis protein 4 for detection of ovarian carcinoma in adnexal masses: A pilot study

2016 ◽  
Author(s):  
Nidhi Bansal ◽  
A. Suneja ◽  
K. Guleria ◽  
N. B. Vaid ◽  
K. Mishra ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Cross Sectional Study ◽  
Ca 125 ◽  
Serum Samples ◽  
Cross Sectional ◽  
Adnexal Masses ◽  
Good Discriminator ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index ◽  
Benign Tumours

Introduction: HE4 is a novel tumour biomarker used for early diagnosis of ovarian cancer. This study evaluated the diagnostic accuracy of HE4 alone and in combination with CA125, risk of malignancy index (RMI), risk of malignancy algorithm (ROMA). Methods: It was a cross sectional study conducted recruiting 88 women with adnexal masses who were planned for surgery. After baseline work up and ultrasound examination, serum samples were collected for estimation of CA 125 and HE4 levels. Serum HE4 levels were estimated using ELISA kit. RMI and ROMA score were calculated and diagnostic accuracy of HE4, CA 125, RMI, ROMA and their combination were compared. Cut off for HE4 and ROMA score were calculated using ROC curve. Results: Of 88 subjects, 66 were analyzed with 19 malignant (including 5 LMP) and 47 benign cases. The median value of HE4 among malignant cases was found to be significantly higher than among the benign cases. PPV and NPV of HE4 at a cut off 130.8 pMol/ml was 85.7% and 77.9% respectively. Highest PPV (88.9%) with acceptable NPV (80.7%) was found with ROMA followed by HE4 (PPV 85.7%; NPV 77.97%), RMI (PPV 76.92%; NPV 83%) and CA125 (PPV 52%; NPV 80.85%). Conclusion: HE4 levels were lower in Indian population both in malignant and benign tumours as compared to other studies. HE4 is a good discriminator and gives best accuracy when it is combined with CA125 in a logistic algorithm, ROMA.

Evaluation of Adnexal Masses-Correlation of Clinical, Sonological and Histological Findings in Adnexal Masses

2020 ◽  
Vol 22 (4) ◽  
pp. 199-202
Author(s):  
Manisha Acharya ◽  
P Kumar ◽  
BB Shrestha ◽  
S Shrestha ◽  
R Amatya ◽  
...  
Keyword(s):  
Predictive Value ◽  
Adnexal Mass ◽  
Diagnostic Value ◽  
Mean Value ◽  
Ca 125 ◽  
Histopathological Diagnosis ◽  
Adnexal Masses ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index ◽  
Clinical Records

Adnexal mass is a common clinical finding in gynaecological practice. The study aims to find out the diagnostic value of clinical examination, ultrasonography and Ca-125 and its correlation, using Risk of Malignancy Index with histopathological diagnosis in adnexal masses. Clinical records were retrieved of women who had surgical management for adnexal mass in the last 2 years duration. Based on the data, Risk of Malignancy Index values were calculated. It was then compared with histopathological diagnosis. Out of 66 patients, 56 patients had benign tumor and 10 patients had malignancy. The Risk of Malignancy Index values of each patient was calculated which ranged from 8 to 2205 with mean value of 425.52 (SD±41.8). Risk of Malignancy Index sensitivity was 70%, specificity was 96.42%, positive predictive value was 77.78%, and negative predictive value was 95.83%. Risk of Malignancy Index is a reliable diagnostic tool in differentiating benign from malignant adnexal masses.

scholarly journals Diagnostic extended usefulness of RMI: comparison of four risk of malignancy index in preoperative differentiation of borderline ovarian tumors and benign ovarian tumors

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Shuang Zhang ◽  
Shan Yu ◽  
Wenying Hou ◽  
Xiaoying Li ◽  
Chunping Ning ◽  
...  
Keyword(s):  
Ovarian Tumor ◽  
Menopausal Status ◽  
Area Under The Curve ◽  
Ovarian Tumors ◽  
Borderline Ovarian Tumor ◽  
Cancer Antigen 125 ◽  
Borderline Ovarian Tumors ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index ◽  
Benign Ovarian Tumors

Abstract Background This study aimed to examine the performance of the four risk of malignancy index (RMI) in discriminating borderline ovarian tumors (BOTs) and benign ovarian masses in daily clinical practice. Methods A total of 162 women with BOTs and 379 women with benign ovarian tumors diagnosed at the Second Affiliated Hospital of Harbin Medical University from January 2012 to December 2016 were enrolled in this retrospective study. Also, we classified these patients into serous borderline ovarian tumor (SBOT) and mucinous borderline ovarian tumor (MBOT) subgroup. Preoperative ultrasound findings, cancer antigen 125 (CA125) and menopausal status were reviewed. The area under the curve (AUC) of receiver operator characteristic curves (ROC) and performance indices of RMI I, RMI II, RMI III and RMI IV were calculated and compared for discrimination between benign ovarian tumors and BOTs. Results RMI I had the highest AUC (0.825, 95% CI: 0.790–0.856) among the four RMIs in BOTs group. Similar results were found in SBOT (0.839, 95% CI: 0.804–0.871) and MBOT (0.791, 95% CI: 0.749–0.829) subgroups. RMI I had the highest specificity among the BOTs group (87.6, 95% CI: 83.9–90.7%), SBOT (87.6, 95% CI: 83.9–90.7%) and MBOT group (87.6, 95% CI: 83.9–90.7%). RMI II scored the highest overall in terms of sensitivity among the BOTs group (69.75, 95% CI: 62.1–76.7%), SBOT (74.34, 95% CI: 65.3–82.1%) and MBOT (59.18, 95% CI: 44.2–73.0%) group. Conclusion Compared to other RMIs, RMI I was the best-performed method for differentiation of BOTs from benign ovarian tumors. At the same time, RMI I also performed best in the discrimination SBOT from benign ovarian tumors.

scholarly journals Comparison of the Diagnostic Performances of Ultrasound-Based Models for Predicting Malignancy in Patients With Adnexal Masses

2021 ◽  
Vol 11 ◽  
Author(s):  
Le Qian ◽  
Qinwen Du ◽  
Meijiao Jiang ◽  
Fei Yuan ◽  
Hui Chen ◽  
...  
Keyword(s):  
Prediction Models ◽  
Malignant Tumors ◽  
Roc Curves ◽  
Chinese Patients ◽  
Likelihood Ratios ◽  
Predictive Values ◽  
Adnexal Masses ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index ◽  
Accuracy Study

AimThis study aimed to compare different ultrasound-based International Ovarian Tumor Analysis (IOTA) prediction models, namely, the Simple Rules (SRs) the Assessment of Different NEoplasias in the adneXa (ADNEX) models, and the Risk of Malignancy Index (RMI), for the pre-operative diagnosis of adnexal mass.MethodsThis single-centre diagnostic accuracy study involved 486 patients. All ultrasound examinations were analyzed and the prediction models were applied. Pathology was the clinical reference standard. The diagnostic performances of prediction models were measured by evaluating receiver-operating characteristic curves, sensitivities, specificities, positive and negative predictive values, positive and negative likelihood ratios, and diagnostic odds ratios.ResultsTo discriminate benign and malignant tumors, areas under the ROC curves (AUCs) for ADNEX models were 0.94 (95% CI: 0.92–0.96) with CA125 and 0.94 (95% CI: 0.91–0.96) without CA125, which were significantly higher than the AUCs for RMI I-III: 0.87 (95% CI: 0.83–0.90), 0.83 (95% CI: 0.80–0.86), and 0.82 (95% CI: 0.78–0.86), (all P < 0.0001). At a cut-off of 10%, the ADNEX model with CA125 had the highest sensitivity (0.93; 95% CI: 0.87–0.97) compared with the other models. The SRs model achieved a sensitivity of 0.93 (95% CI: 0.86–0.97) and a specificity of 0.86 (95% CI: 0.82–0.89) when inconclusive diagnoses (11.7%) were classified as malignant.ConclusionADNEX and SRs models were excellent at characterising adnexal masses which were superior to the RMI in Chinese patients.

Performance of the Risk of Malignancy Index for Discriminating Malignant Tumors in Women With Adnexal Masses

2016 ◽  
Vol 35 (1) ◽  
pp. 143-152 ◽  
Author(s):  
Camila Campos ◽  
Luis Otávio Sarian ◽  
Rodrigo Menezes Jales ◽  
Caio Hartman ◽  
Karla Galvão Araújo ◽  
...  
Keyword(s):  
Malignant Tumors ◽  
Adnexal Masses ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index

scholarly journals Risk of Malignancy Index Has a Poor Sensitivity in Detecting Borderline Epithelal Tumors and Non-Epithelial Ovarian Tumors

2019 ◽  
pp. 1
Author(s):  
Yasin Durmus ◽  
Mehmet Mutlu Meydanli
Keyword(s):  
Predictive Value ◽  
Ovarian Tumors ◽  
Ca 125 ◽  
Histopathological Diagnosis ◽  
Adnexal Masses ◽  
Epithelial Tumors ◽  
Ovarian Cancers ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index ◽  
The Difference

<p><strong>Objectives:</strong> To evaluate diagnostic accuracy of "Risk Of Malignancy İndex-1" (RMI-1) for postmenopausal adnexal masses.</p><p><strong>Study Design:</strong> Fifty postmenopausal women who had undergone surgery because of adnexal masses were included in this prospective study. RMI-1 scores were calculated through the formula: [RMI= Ultrasound Score x Menopause Score x Serum Ca-125 Level] and noted preoperatively by the same sonographer for each case. "Final histopathological diagnosis" was accepted as gold standard for benign-malignant categorical distribution. Borderline tumors were categorized in malignant tumor group.<br /><strong></strong></p><p><strong>Results:</strong> According to final histopathological results; 20 of the 50 patients had malignant adnexal masses. Twelve of them had invasive epithelial tumors. The remaining 8 patients had borderline epithelial tumors or non-epithelial ovarian cancers. When the RMI score ≥200 was accepted as a positive test result compatible with the literature; we calculated the sensitivity: 75%, specificity: 93%, positive predictive value: 88%, negative predictive value: 85% predicting malignant adnexal masses. All of the 12 patients with invasive epithelial tumors had RMI-1 scores higher than 200. Nevertheless, only 3 of the 8 patients with borderline epithelial tumors or non-epithelial ovarian cancers had RMI-1 scores higher than 200. We have found out that invasive epithelial tumors had higher USG Scores, Ca-125 Levels and RMI Scores when compared to borderline epithelial tumors and non-epithelial ovarian cancers and the difference was statistically significant.<br /><strong></strong></p><p><strong>Conclusions:</strong> RMI-1 is a valuable and applicable method in the initial evaluation of postmenopausal patients with adnexal masses. İt has a high diagnostic performance in detecting invasive epithelial ovarian cancers, but it has a poor sensitivity in detecting borderline ovarian tumors and non-epithelial ovarian cancers.</p>

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