Evaluation of Risk of Malignancy Index 5—A New Indicator in Differentiating Benign and Malignant Ovarian Masses

JOURNAL TITLE: Journal of South Asian Federation of Obstetrics and Gynaecology

1. Pandu Dasappa
2. Nirmala C Shekar
3. Nagendra P Nagothi
4. Nagarathnamma Rangaiah
Publishing Year
Author Affiliations
1. com.mps.common.model.Contributor@4f3c2b5 ,
2. com.mps.common.model.Contributor@3e95d0c9 ,
3. com.mps.common.model.Contributor@75bc7d12 ,
4. com.mps.common.model.Contributor@4259e66d
Article keywords
CA125, Menopausal status, Risk of malignancy index, Ultrasound score


Objective: To evaluate the effectiveness of the risk of malignancy index 5 (RMI5)—a new indicator in differentiating benign and malignant ovarian masses. To compare RMI5 with RMI1, RMI2, RMI3, RMI4, and the individual parameters (CA125, ultrasound score, and menopausal status). Materials and methods: It is a 5-year retrospective record analysis of women admitted with ovarian masses. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy of RMI1, RMI2, RMI3, RMI4, RMI5, and CA125, ultrasound score, and menopausal status were calculated. Results: Risk of malignancy index 5 is a better indicator of malignancy compared to the other indices. This study confirms that the five RMI indices were more accurate than menopausal status, CA125 level, and ultrasound score separately. RMI2 and RMI5 had p = 0.047 and 0.034, respectively, and hence were more accurate as compared to other indices by univariate analysis. Risk of malignancy index 5 had sensitivity and specificity of 61.5% and 93.17%, respectively, at a cutoff of 25. CA125 has better sensitivity of 80% in detecting malignant ovarian tumors than other individual parameters. Conclusion: Risk of malignancy index 5 better discriminates malignant from benign ovarian masses as compared to other malignancy indices.

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