Risk of malignancy index in preoperative evaluation of pelvic masses.

OBJECTIVE The aim of this study was to evaluate the use of risk of malignancy index (RMI) based on a serum CA125 level, ultrasound findings and menopausal status in primary evaluation of patients with adnexal masses in daily clinical practice. METHODS One hundred and fifty one women with adnexal masses were enrolled. Ultrasound characteristics, menopausal status and serum CA125 level were documented preoperatively, and combined into the RMI afterwards. The sensitivity, specificity, positive (PPV) and negative predictive values (NPV) of the RMI in prediction of ovarian cancer were calculated. RESULTS The RMI identified malignant cases more accurately than any individual criterion in diagnosing ovarian cancer. Using a cut-off level of 238 to indicate malignancy, the RMI showed a sensitivity of 89.5%, a specificity of 96.2%, a PPV of 77.3%, a NPV of 98.4% and an accuracy of 95.4%. CONCLUSION RMI is a simple, easily applicable method in the primary evaluation of patients with adnexal masses of high risk of malignancy, resulting in timely referal to gynecological oncology centers for suitable surgical operations.