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%.

scholarly journals Evaluation of risk malignancy index in the pre-operative diagnosis of benign and malignant ovarian neoplasms

2018 ◽  
Vol 7 (8) ◽  
pp. 3126
Author(s):  
Niroopama Pushpagiri ◽  
Saranya Nagalingam
Keyword(s):  
Predictive Value ◽  
Ovarian Neoplasms ◽  
Menopausal Status ◽  
Tertiary Care ◽  
Ca 125 ◽  
Predictive Values ◽  
Medical College ◽  
Ovarian Tumours ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index

Background: Preoperative discrimination between benign and malignant ovarian neoplasm is necessary to optimally plan for an appropriate surgical treatment. Women with malignant ovarian tumours should be referred to a gynaecologic oncologist for the quality of cytoreductive surgery leading to increased survival. The aim of this study is to determine the role of Risk of Malignancy Index (RMI) incorporating menopausal status, serum CA 125 levels and ultrasound features in discriminating benign from malignant ovarian neoplasms.Methods: A prospective cohort study was conducted for 2 years among 110 women with ovarian neoplasms referred to Narayana Medical College and Hospital, Nellore a tertiary care centre for diagnosis and management. The sensitivity, specificity, positive and negative predictive values of menopausal status, ultrasound finding of ovarian neoplasms, levels of serum CA-125 separately and combined into the RMI were calculated and compared. (RMI = U X M X Serum CA- 125). Women of all ages admitted with ovarian masses in Narayana Medical College, Nellore. Women whose histopathology report turned out to be non-neoplastic ovarian tumours or other adnexal masses.Results: RMI >250 had a sensitivity of 70.8 % (95%CI 54.4-87.2), a specificity of 87% (95%CI 76.5-97.7), a positive predictive value of 81 % and negative predictive value of 79.4% for the diagnosis of malignant neoplasms.Conclusions: The risk of malignancy index is a simple scoring system and easily applicable and effective method for evaluating a patient in discriminating benign and malignant ovarian neoplasms efficiently to optimize therapy. It facilitates timely referral to gynecological oncology unit for adequate staging and optimal debulking.

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 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

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 Risk of malignancy index in ovarian tumour for predicting ovarian malignancy by using Jacob’s score

2017 ◽  
Vol 6 (4) ◽  
pp. 1318
Author(s):  
Rao P. S. ◽  
Bala Reenu ◽  
S. Prajwal
Keyword(s):  
Predictive Value ◽  
Case Fatality ◽  
Ovarian Tumors ◽  
Ca 125 ◽  
Ovarian Malignancy ◽  
Gynecological Malignancy ◽  
Menopausal Women ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index ◽  
Post Menopausal

Background: Ovarian malignancy is the most common gynecological malignancy after the cancer of the cervix. A woman's risk at birth of ovarian cancer at some time in her life is 1 % to 1.5% and that of dying from cancer is almost 0.5 %. The most commonly occurring ovarian tumors are of epithelial in origin. It has the highest case-fatality ratio of all gynecological malignancies. Hence the early diagnosis is the most important factor for better prognosis. A clinical evaluation of the patient, followed by ultrasonography and CA-125 is helpful. This study aims to determine the role of Risk of Malignancy Index (Jacob’s RMI) in ovarian tumors for prediction of ovarian malignancy.Methods: This is a prospective cohort study. The present study was carried out at department of OBG, in collaboration with the Departments of Radio diagnosis and Pathology, AHRR, New Delhi. 100 patients meeting the inclusion and exclusion criteria were considered. Detailed clinical history, examination and ultrasonography (Abdomen and pelvis) were done. Estimation of CA125 was done thereafter. Calculated JACOBS RMI score was compared with operative surgical staging and histopathological-cytological examination of the specimen. Data obtained thereafter was analysed using appropriate and relevant statistical software.Results: In present study sensitivity of RMI Score in the pre-menopausal women was 66.7% and in post-menopausal women was 83.3%. Specificity of RMI Score in the pre-menopausal women was 96.3% and in post-menopausal women was 81.8%. The positive predictive value in the pre-menopausal women was 40% and in post-menopausal women was 71.4%. The negative predictive value in the pre-menopausal women was 98.7% and in post-menopausal women was 90%. Diagnostic accuracy in a case of premenopausal women was is 95.2% and 82.4% for postmenopausal women.Conclusions: The present study shows that RMI Score helps in identifying effectively those patients who require Staging Laparotomy and hence referral to Gynecologist Oncologist. Patients with ovarian masses with low risk of malignancy index can be treated by minimal access procedures.

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>

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.

scholarly journals International Ovarian Tumor Analysis (IOTA) Scoring System to Predict Ovarian Malignancy Preoperatively

2016 ◽  
Author(s):  
Yuri Feharsal ◽  
Andi D Putra
Keyword(s):  
Predictive Value ◽  
Ovarian Tumor ◽  
Diagnostic Performance ◽  
Ca 125 ◽  
Ovarian Malignancy ◽  
Scoring Method ◽  
Simple Rules ◽  
Histopathology Result ◽  
Risk Of Malignancy ◽  
Sensitivity Specificity

Objective: To compare diagnostic performance of International Ovarian Tumor Analysis (IOTA) scoring method with Risk of Malignancy Index-4 (RMI-4) and Sassone Morphology Index to predict ovarian malignancy preoperatively. Method: Retrospective study with 119 subject who underwent surgical removal of ovarian tumor and performed histopathological examination at Dr. Cipto Mangunkusumo Hospital on January to December 2013. Demographic status, ultrasound scans, CA-125 level and histopathological result were collected to calculate the score of each method. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated by comparing each score with histopathology result. Comparison of diagnostic performance was analyzed by ROC curve. Result: There were 51.26% subjects with benign tumor and 48.74% subjects with malignant tumor. Result was analyzed with sensitivity test (IOTA simple-rules, IOTA subgroup, RMI-4 and Sassone): 98%, 88%, 86% and 79%; specificity: 74%, 67%, 61% and 89%; positive predictive value: 78%, 72%, 68% and 87%; negative predictive value: 98%, 85%, 82% and 81%; and accuracy: 86%, 77%, 73% and 84%. AUC value for IOTA simple-rules, IOTA subgroup, RMI-4 and Sassone were: 0.86, 0.78, 0.73 and 0.84. Comparison of these results were significant with p = 0.000. Conclusion: IOTA simple-rules had better sensitivity, negative predictive value and accuracy than IOTA subgroup, RMI-4 and Sassone morphology index to predict ovarian malignancy preoperatively. [Indones J Obstet Gynecol 2016; 1: 42-46] Keywords: iota, ovarian neoplasm, risk of malignancy, scoring

Sign in / Sign up

Export Citation Format

Share Document