scholarly journals The adnexal mass: Benign or malignant? Evaluation of risk of malignancy index

2016 ◽  
Vol 6 (2) ◽  
pp. 127
Author(s):  
Shamsun Nahar ◽  
Latifa Shamsuddin
Keyword(s):  
Adnexal Mass ◽  
Histopathological Examination ◽  
Menopausal Status ◽  
Abdominal Ultrasound ◽  
Ovarian Malignancy ◽  
Abdominal Ultrasonography ◽  
Serum Ca125 ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index ◽  
Ultrasound Score

<p><strong>Background:</strong> Screening programme for ovarian malignancy is an international public demand. <strong></strong></p><p><strong>Ojective:</strong> To validate a risk of malignancy index (RMI) incorporating serum CA125, abdominal ultrasound findings and menopausal status for preoperative diagnosis of ovarian malignancy among patient with adnexal mass.</p><p><strong>Methods:</strong> This prospective observa­tional study was conducted on 57 patients having adnexal mass admitted consecutively for surgical exploration in BSMMU from January 2000 to March 2001. S. CA125 assay &amp; abdominal ultrasonography was done within 10 days preoperatively. Ultrasound score (0, 1 &amp; 3) using 5 sonographic features &amp; menopausal score (1 &amp; 3) were calculated. RMI was detected by the formula "RMI = Ultrasound score - Menopausal score - S. CA125 level" Definitive diagnosis was based on histopathological examination.</p><p>See PDF for the rest of the abstract.</p>

scholarly journals Sonographic Prediction of Ovarian Malignancy in Adnexal Mass

2016 ◽  
Vol 27 (2) ◽  
pp. 67-71
Author(s):  
Shamsun Nahar ◽  
Latifa Shamsuddin ◽  
Mariam Faruqui ◽  
Gulshan Ara
Keyword(s):  
Adnexal Mass ◽  
Menopausal Status ◽  
Ovarian Malignancy ◽  
Chi Square ◽  
Abdominal Ultrasonography ◽  
Predictive Values ◽  
Serum Ca125 ◽  
Ultrasound Score ◽  
Sensitivity Specificity

Objective: To evaluate the role of ultrasound for preoperative diagnosis of ovarian malignancy in adnexal mass.Materials & Methods: This prospective observational study was conducted on patients having adnexal mass (n-57) admitted consecutively for surgical exploration in Dept. of OB-GYN of BSMMU from January 2000 - March 2001. Abdominal ultrasonography was performed 10 days preoperatively and 5 sonographic criteria were used to calculate ultrasound score (0, 1 & 3 ). Definitive diagnosis was based on histo-pathological study . Sensitivity , specificity , positive and negative predictive values of ultrasound score to diagnose ovarian malignancy were detected . Chi square & student’s ‘t’ test were used for statistical analysis .Results: Sensitivity , specificity , positive and negative predictive values of ultrasound score at cut-off value of 3 were 78% , 80% , 47% and 94 % respectively .Conclusion: For pre-operative diagnosis of ovarian malignancy sonographic scoring system may be introduced easily into the clinical practice where other complementary tests are not available. Combination of serum CA125 and menopausal status into ultrasound score may further improve the diagnostic accuracy in prediction of ovarian malignancy preoperatively.Bangladesh J Obstet Gynaecol, 2012; Vol. 27(2) : 67-71

scholarly journals Role of risk of malignancy index for evaluation and preoperative detection of pelvic malignancies compared with pathological diagnosis

2020 ◽  
Vol 9 (9) ◽  
pp. 3611
Author(s):  
Beenish Yousseff ◽  
Mariya Amin Qurieshi ◽  
Nadiya Yousseff
Keyword(s):  
Predictive Value ◽  
Menopausal Status ◽  
Histopathological Diagnosis ◽  
Ovarian Malignancy ◽  
Cross Sectional ◽  
Jammu And Kashmir ◽  
Pelvic Malignancies ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index ◽  
Ultrasound Score

Background: Risk of malignancy index (RMI) is widely employed in the developed world in predicting malignant pelvic masses. The present study designed to confirm the effectiveness of the RMI to identify cases with high potential of ovarian malignancy, among patients with an adnexal mass.Methods: This was a cross-sectional study was conducted over a period of two years in a government run tertiary healthcare centre of Srinagar, Kashmir, Jammu and Kashmir, India. Study included 72 patients who underwent surgery due to adnexal mass and were evaluated for ovarian malignancy by comparing RMI with histopathological diagnosis. Data collected included demographic characteristics, ultrasound findings, menopausal status, CA125 levels, and histopathological diagnosis. For each patient, RMI was calculated as per the standard formula.Results: Analysis revealed ultrasound score had the highest sensitivity of 72.7%, while an RMI score ≥250 had the highest specificity of 88.5%. The latter also had the highest positive predictive value of 50%, while negative predictive value was highest for an ultrasound score of 3 (94%). The cut off points based on ROC analysis demonstrates significant predictive ability for ovarian cancer for both RMI and CA125 with AUC to the tune of 82.9% and 80.1% respectively.Conclusions: RMI is a simple score system which can be applied directly into clinical practice and might be of value in pre-operative assessment, and hence selecting patients who need surgical team including gynecologic oncologists.

Risk of malignancy index for referral of ovarian cancer cases to a tertiary center: does it identify the correct cases?

2006 ◽  
Vol 16 (Suppl 1) ◽  
pp. 30-34 ◽  
Author(s):  
J. Bailey ◽  
A. Tailor ◽  
R. Naik ◽  
A. Lopes ◽  
K. Godfrey ◽  
...  
Keyword(s):  
Menopausal Status ◽  
Pelvic Mass ◽  
Cancer Center ◽  
Benign Tumors ◽  
Ovarian Malignancy ◽  
Diverse Range ◽  
Tertiary Center ◽  
Serum Ca125 ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index

Characterization of adnexal masses to identify patients with malignant ovarian tumors preoperatively for referral to a cancer center for treatment has been extensively studied. A simple algorithm called “risk of malignancy index” (RMI) reported by Jacobs incorporated the serum CA125 level, menopausal status, and ultrasound morphologic features. This algorithm has subsequently been tested on retrospective and prospective data with encouraging results. However, these studies did not include cases that had had both their serum CA125 measurements and ultrasound examinations from a diverse range of laboratories and sonographers. The purpose of this study was to determine the effectiveness of the RMI algorithm for identifying cases of ovarian malignancy presenting at cancer units for subsequent referral to a cancer center. All cases of suspected ovarian malignancy referred to the Northern Gynaecological Oncology Centre (NGOC) during an 18-month period were identified from the NGOC database. A case note review was performed, and the following data were extracted: patient demographics, the referring physician and the operating surgeon, ultrasound morphology, serum CA125 levels, and menopausal status. All patients had their ultrasound performed by sonographers at the peripheral unit according to local protocols. A total of 182 patients with a pelvic mass were referred to the center for surgery. A total of 24% patients had benign tumors, 6% had tumors of borderline malignancy, and 70% had invasive tumors. A total of 145 cases had an RMI >200; 125 of these had ovarian or peritoneal cancers. An RMI >200 had a sensitivity of 88.5% for diagnosing invasive lesions. The overall sensitivity of this algorithm for diagnosing all borderline, invasive ovarian, or primary peritoneal lesions was 87.4%, and the positive predictive value was 86.8%. Our data confirm the effectiveness of the RMI algorithm in clinical practice for the identification and subsequent referral to cancer centers of cases of potential ovarian malignancy. We therefore recommend its continued use.

scholarly journals Evaluation of HE4, CA-125, Risk of Ovarian Malignancy Algorithm (ROMA) and Risk of Malignancy Index (RMI) in the Preoperative Assessment of Patients with Adnexal Mass

2016 ◽  
Vol 31 (5) ◽  
pp. 336-344 ◽  
Author(s):  
Khawla Al Musalhi ◽  
Manal Al Kindi ◽  
Faiza Al Aisary ◽  
Fatma Ramadhan ◽  
Thuraya Al Rawahi ◽  
...  
Keyword(s):  
Adnexal Mass ◽  
Preoperative Assessment ◽  
Ca 125 ◽  
Ovarian Malignancy ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index

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 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.

scholarly journals Can Replacing CA125 with HE4 in Risk of Malignancy Indices 1–4 Improve Diagnostic Performance in the Presurgical Assessment of Adnexal Tumors?

2017 ◽  
Vol 2017 ◽  
pp. 1-12
Author(s):  
Nabil Abdalla ◽  
Robert Piórkowski ◽  
Paweł Stanirowski ◽  
Krzysztof Cendrowski ◽  
Włodzimierz Sawicki
Keyword(s):  
Diagnostic Performance ◽  
Adnexal Mass ◽  
Characteristic Curve ◽  
Menopausal Status ◽  
Significant Difference ◽  
Serum Ca125 ◽  
Risk Of Malignancy ◽  
Presurgical Assessment ◽  
Performance Area ◽  
Adnexal Tumors

Aims. To assess whether replacing CA125 with HE4 in the classical formulas of risk of malignancy indices (RMIs) can improve diagnostic performance. Methods. For each of 312 patients with an adnexal mass, classical RMIs 1–4 were computed based on ultrasound score, menopausal status, and serum CA125 levels. Additionally, modified RMIs (mRMIs) 1–4 were recalculated by replacing CA125 with HE4. Results. Malignant pathology was diagnosed in 52 patients (16.67%). There was no significant difference in diagnostic performance (area under the receiver operating characteristic curve [AUC]) between each classical RMI and its corresponding mRMI. In the entire sample, the AUC was 0.899, 0.900, 0.895, and 0.908 for classical RMIs 1–4 compared to 0.903, 0.929, 0.930, and 0.931 for mRMIs 1–4. In premenopausal patients, the AUC was 0.818, 0.798, 0.795, and 0.802 for classical RMIs 1–4 compared to 0.839, 0.875, 0.876, and 0.856 for mRMIs 1–4. In postmenopausal patients, the AUC was 0.906, 0.895, 0.896, and 0.906 for classical RMIs 1–4 compared to 0.907, 0.923, 0.924, and 0.930 for mRMI 1–4. Conclusions. Use of HE4 instead of CA125 did not significantly improve diagnostic performance of RMIs 1–4 in patients with an adnexal mass.

Evaluation of a Risk of Malignancy Index Based on Serum CA125, Ultrasound Findings and Menopausal Status in the Pre-Operative Diagnosis of Pelvic Masses

1997 ◽  
Vol 52 (3) ◽  
pp. 179-180
Author(s):  
Solveig Tingulstad ◽  
Bjorn Hagen ◽  
Finn Egil Skjeldestad ◽  
Mathias Onsrud ◽  
Torvid Kiserud ◽  
...  
Keyword(s):  
Menopausal Status ◽  
Ultrasound Findings ◽  
Pelvic Masses ◽  
Serum Ca125 ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index
Sign in / Sign up

Export Citation Format

Share Document