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.

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 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.

Improved Detection Rate of Ovarian Cancer Using a 2-Step Triage Model of the Risk of Malignancy Index and Expert Sonography in an Outpatient Screening Setting

2016 ◽  
Vol 26 (6) ◽  
pp. 1062-1069 ◽  
Author(s):  
Gwendolin Manegold-Brauer ◽  
Johanna Buechel ◽  
Alexandra Knipprath-Mészaros ◽  
Andreas Schoetzau ◽  
Neville F. Hacker ◽  
...  
Keyword(s):  
Pattern Recognition ◽  
Tumor Marker ◽  
Outpatient Clinic ◽  
Predictive Value ◽  
Detection Rate ◽  
Menopausal Status ◽  
Adnexal Masses ◽  
Step Model ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index

ObjectivePreoperative assessment of adnexal masses with ultrasound has been shown to be time-, cost-effective, and specific. When used in combination with the menopausal status and the tumor marker CA125, the risk of malignancy index (RMI) can be calculated, allowing appropriate preoperative triage of patients to a gynecologist or a gynecological oncologist. Moreover, it allows for accurate planning of the required surgical procedure (laparoscopy vs laparotomy).MethodsA large general gynecologic ultrasonic database retrospectively identified 5218 patients for a 14-year period who presented to the outpatient clinic with an adnexal mass. Additional data (menopausal status, histology, CA125 values) were available in 1108 of these patients. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated. The results were then compared with previously published data from a large Australian gynecological cancer center (GCC, n = 204).ResultsWith the use of an RMI cutoff of 200, malignant ovarian tumors were correctly triaged to a gynecologic oncologist in 123 of 172 cases, leading to a sensitivity of 72% and specificity of 92% in our general outpatient clinic population compared with a sensitivity of 84% and a specificity of 77% in the GCC high-risk population. The negative predictive value was 95% compared with only 85% in the GCC cohort. We hypothesize that improvement of the overall detection rate of malignancy could be improved from 72% to 85% using a 2-step model, referring patients with an ultrasonic score of 3 to an experienced sonographer who uses pattern recognition.ConclusionsThe RMI is an easy and reliable tool for the accurate triage of adnexal masses. Its value is higher in an unselected gynecological outpatient setting. Our proposed 2-step model including expert pattern recognition could influence particularly the detection rate in borderline and early-stage ovarian cancers and overcome the limitations of the tumor marker CA125.

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 The predictive value of risk of malignancy index calculation in adnexal masses

2013 ◽  
Vol 4 (3) ◽  
Author(s):  
Fisun Vural ◽  
Sinem Ertaş ◽  
Gültekin Köse ◽  
Ayşe Deniz Ertürk Coşkun ◽  
Ertuğrul Can Tüfekçi ◽  
...  
Keyword(s):  
Predictive Value ◽  
Adnexal Masses ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index ◽  
Index Calculation

Feasibility of Thyroid Imaging Reporting and Data System Classification in Predicting Thyroid Malignancy

2019 ◽  
Vol 85 (12) ◽  
pp. 1345-1349
Author(s):  
Ahmet Cem Dural ◽  
Nuri Alper Sahbaz ◽  
Cevher Akarsu ◽  
Sezer Akbulut ◽  
Rustu Turkay ◽  
...  
Keyword(s):  
Predictive Value ◽  
Daily Practice ◽  
Diagnostic Value ◽  
Data System ◽  
Thyroid Malignancy ◽  
Predictive Values ◽  
Thyroid Imaging ◽  
Ultrasound Findings ◽  
Risk Of Malignancy ◽  
Sensitivity Specificity

In this study, we aimed to evaluate the diagnostic value of thyroid imaging reporting and data system (TIRADS) in the estimation of malignancy and assess the concordance between TIRADS and the histopathology results of the postoperative specimens. Consecutive ultrasound imaging records of patients with multinodular goiter from January 2010 to December 2017 who underwent surgery were retrospectively reviewed. The risk of malignancy of each TIRADS category was determined, and correlation with pathology was assessed. The patients with malignant cytology findings (Bethesda 6) who were categorized TIRADS 6 were excluded from the study. The positive and negative predictive values, sensitivity, specificity, and accuracy of the TIRADS classification were calculated on a 2 x 2 table with their own formulas. A total of 1457 patients were evaluated, and 1122 of these were included in the study. The risk of malignancy for nodules evaluated as TIRADS 2 was 0.6 per cent, TIRADS 3 was 13.1 per cent, TIRADS 4a was 20 per cent, TIRADS 4b was 61.1 per cent, TIRADS 4c was 85.7 per cent, and TIRADS 5 was 93.3 per cent. The positive predictive value of TIRADS classification was found to be 43.4 per cent, negative predictive value was found to be 90.7 per cent, sensitivity was found to be 78 per cent, specificity was found to be 68.4 per cent, and accuracy was found to be 70.7 per cent for our institution. The TIRADS classification based on suspicious ultrasound findings is reliable in predicting thyroid malignancy and can be routinely used in daily practice.

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 Assessment of diagnostic value of Serum Ca-125 and risk of malignancy index scoring in the evaluation of adnexal masses

2019 ◽  
Vol 10 (4) ◽  
pp. 192
Author(s):  
Anupama Bahadur ◽  
Kavita Khoiwal ◽  
Ranjeeta Kumari ◽  
Namrata Bhattacharya ◽  
Shalinee Rao ◽  
...  
Keyword(s):  
Diagnostic Value ◽  
Ca 125 ◽  
Adnexal Masses ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index

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

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