A prospective study of comparison of risk of malignancy indices (RMIs) in evaluation of ovarian neoplasm at a rural tertiary hospital in central India

Abstract

To evaluate the ability of four types of the risk of malignance indices (RMI) based on serum levels of Ca-125, ultrasound score and menopausal status to discriminate between benign and malignant ovarian tumours. Methods: it was a Prospective cross sectional Study conducted in the Department of Obstetrics and Gynecology. During this study 300 women were enrolled in the study over a period of 1 1/2 years (December 2015-July 2017). The RMI was evaluated for sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) with reference to the actual presence of a malignant or benign pelvic tumour. Results: In this study out of 300 patients with clinically suspected ovarian tumours were included. RMI 1,2,3,4 was calculated according to their formula. Sensitivity of RMI-1, 2, 3 and 4 was calculated to be 63.43%, 77.61%, 63.43% and 76.49% respectively. Specificity of RMI-1, 2, 3 and 4 was calculated to be 68.75%, 65.62%, 65.62% and 62.50% respectively. RMI-2 and RMI-4 had maximum sensitivity while RMI-1 had maximum specificity. Overall RMI-2 appears to be the most accurate of all the four RMI. Conclusions: Overall RMI 2 appears to be more accurate of all.it may be concluded that, the RMI is a simple scoring system with higher accuracy in differentiating benign from malignant ovarian masses, it can be easily introduced in clinical practice and can be the test of choice in the preoperative evaluation of the adnexal mass under primary settings. Based on our study, RMI 2 use with ultrasound findings can be a useful and applicable method for initial assessment of patients with pelvic masses.