External validation of the adapted Risk of Malignancy Index incorporating tumor size in the preoperative evaluation of adnexal masses

Abstract

Both RMI-3 and RMI-4 were able to discriminate between non-invasive lesions and invasive malignant adnexal masses, with similar performances. Including tumor size in the RMI does not improve its performance.

Validation of the Risk of Malignancy Index in primary evaluation of ovarian masses

“…The performance of RMI-3 and RMI-4 reported in this study was in agreement with many previous studies (8,24). Both RMI-3 and RMI-4 are accurate in predicting malignant ovarian masses than in borderline cases.…”

“…This study has addressed the performances of RMI-3 at a cut-off value of 200 and RMI-4 at cut-off value of 450 in preoperative evaluation of adenxal masses. At these cut-off levels, RMI-3 (9-11) and RMI-4 (8,21,24) reported the best performance in previous studies.…”

“…In this study, tumor size was measured preoperatively by ultrasound for each patient in agreement with Yamamoto et al (21), whereas Petronella et al, 2011 (24) have extracted this information from the pathology report. We used cutoff level of 7 cm to calculate RMI-4.…”

“…Since 1990, three versions of the RMI have been validated in different clinical studies. Recently, a fourth version of the RMI (RMI-4) was introduced that includes tumor size as an additional parameter (24). This study has addressed the performances of RMI-3 at a cut-off value of 200 and RMI-4 at cut-off value of 450 in preoperative evaluation of adenxal masses.…”

Preoperative evaluation of patients with ovarian masses using the risk of malignancy index 4 model

“…Most previous studies confirm this finding, as in the 2011 study by Petronella et al, which found that tumor size was useless for diagnosis of malignant ovarian masses because 60% of benign cases had the tumor size greater than 7 cm. 16 Although serum CA-125 level was high in 85.7% of malignant cases, 20.8% of benign cases also had CA-125 levels above the allowable cut-off level 35 U/mL. Furthermore, high CA-125 levels are known to be indicative of other gynecological conditions such as endometriosis and pelvic infections.…”