Performance of the Risk of Malignancy Index for Discriminating Malignant Tumors in Women With Adnexal Masses

Campos, Camila de Mello; Sarian, Luís Otávio; Jales, Rodrigo Menezes; Hartman, Caio Augusto; Araújo, Karla Galvão; Pitta, Denise da Rocha; Yoshida, Adriana; Andrade, L; Derchain, Sophie

doi:10.7863/ultra.15.01068

Cited by 20 publications

(22 citation statements)

References 31 publications

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“…Previous studies have demonstrated that, using subjective ultrasound evaluation, more than 50% of BOT were classified incorrectly as benign or unclassifiable and more than 60% were confused with other histopathological diagnoses. In addition, IOTA simple rules and non‐IOTA models had poorer performance for identifying BOT and Stage I OC than did the IOTA ADNEX model in our study. We found that the IOTA ADNEX model did not perform well in discriminating BOT and ovarian metastasis from Stage I OC.…”

Section: Discussioncontrasting

confidence: 59%

Performance of the IOTA ADNEX model in preoperative discrimination of adnexal masses in a gynecological oncology center

Araújo

Jales

Pereira

et al. 2017

Ultrasound in Obstet & Gyne

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Section: Discussioncontrasting

confidence: 59%

Performance of the IOTA ADNEX model in preoperative discrimination of adnexal masses in a gynecological oncology center

Araújo

Jales

Pereira

et al. 2017

Ultrasound in Obstet & Gyne

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“…[9] , [14] The chances of ovarian malignancy increases in proportionate with the increasing age. [16] In the present study 76.36% were diagnosed with malignancy in postmenopausal group and 16.88% of the same group were with benign tumours. The Menopausal Status of our study gave a sensitivity of 72.7 % and specificity of 83.1% for diagnosing malignant cases.…”

Section: Discussionsupporting

confidence: 46%

“…Our study matched with B R Obiedat et al and Campos et al with a area under curve of 0.91 and 0.85 respectively. [16] , [18] In our study the ability of RMI to differentiate adnexal masses preoperatively as benign or malignant is statistically significant as shown by p value 0.0001 with odds ratio 427.6 (95% CI = 82.98 -2203 ). The combination of serum CA-125 level, USG morphology of pelvic mass and menopausal status have become the root cause for diagnosis of malignant pelvic masses.…”

Section: Discussionmentioning

confidence: 49%

“…[8] In 2016 Campos et al observed with a RMI -4 cut off of 450 the sensitivity, specificity, PPV, NPV were 86%, 91%, 63% and 97.5% respectively. [16] Aliya B et al in her publication 2015 observed RMI >250 having the sensitivity of 54.05%, specificity of 93.4 %, PPV of 55.5% and NPV of 93.06%. [19] A study done in June 2018 with RMI -4 cut off value of 450 had sensitivity, specificity, PPV, NPV as 67%, 98.7%, 93.1%, 92.4% respectively.…”

Section: Discussionmentioning

confidence: 95%

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Risk of Malignancy Index in Preoperative Evaluation of Adnexal Masses

A¹,

Jajoo²

2018

jemds

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BACKGROUND Ovarian tumour usually presents as adnexal mass but often it is difficult to differentiate between benign and malignant tumour. Several diagnostic modalities such as sonography and tumour markers have been evaluated in the past, but none have been established as an ultimate diagnostic tool individually. The development of a mathematical formula using a logistic model, incorporating menopausal status, the serum level of a glycoprotein called CA-125 and USG score has been described in the form of different malignancy indices. The purpose of this study was to evaluate the various risks of malignancy indices (RMI 4) in the preoperative evaluation of adnexal masses, especially to differentiate between benign and malignant masses. Another objective of the present study is statistical analysis of parameters like specificity, sensitivity, positive predictive value and negative predictive value. MATERIALS AND METHODS The prospective observational study of patients with adnexal masses detected during ultrasonography, who were scheduled for surgical exploration of adnexal mass and histopathological diagnosis, were included in the study. Histopathological examination was taken as gold standard to calculate the accuracy of RMI. The sensitivity, specificity and positive predictive value and negative predictive value of all the four RMI were calculated and data analysed. A total of 100 patients were included in the study over a period of 2 years. RESULTS Sensitivity of RMI-4 was 91.2%. Specificity of RMI was calculated to be 98.7%. Positive and negative predictive values of RMI were 98.1%, and 93.7%, respectively with ROC of 0.95. The best cut off value of RMI is 300. CONCLUSION Risk of Malignancy Index is a good diagnostic tool to differentiate between benign and malignant adnexal masses.

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“…A study from Brazil compared 4 different RMI models, and found them to have similar efficacy and success rates. The positive likelihood ratios of the 4 RMI variants were reported to range from 3.52 to 4.41 (13).…”

Section: Discussionmentioning

confidence: 99%

Preoperative Differentiation Between Malignant and Benign Ovarian Masses in Patients with Normal CA-125 Levels

Ersoy¹,

Tokmak²,

Ersoy³

et al. 2016

Gynecol Obstet Reprod Med

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OBJECTIVE: We aimed to determine the diagnostic values of some clinical and ultrasonographic features for predicting ovarian malignancies in patients with normal serum CA-125 levels. STUDY DESIGN: All of the 84 patients who were diagnosed with ovarian malignancy and 168 patients with benign adnexal mass had normal CA-125 levels, and recruited as study and control groups, respectively. Individual characteristics, ultrasonographic features, and risk of malignancy index (RMI) values of the groups were compared retrospectively. RESULTS: The ages, mean postmenopausal period of the postmenopausal women in the malignant group were significantly higher than the benign group. Nulliparity rates were similar between the two groups. The number of postmenopausal patients was significantly higher in the malignant group. Median cyst diameter and RMI values were significantly higher, and bilaterality and presence of solid area were more frequent in this group. Logistic regression model showed that ovarian cysts larger than 8 cm [Odds ratio (OR): 7.012; p<0.001; 95% Confidence interval (CI): 3.463-14.198], presence of solid area within the cyst [OR: 7.43; p<0.001; 95% CI: 3.799-14.532], and postmenopausal state [OR: 2.893; p=0.027; 95% CI: 1.129-7.412] were found to be significant factors to predict malignancy. CONCLUSION: Ovarian cysts larger than 8 cm, presence of solid area within the cyst, and postmenopausal status are the most important risk factors for ovarian malignancies in these patients with normal CA-125 levels.

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Performance of the Risk of Malignancy Index for Discriminating Malignant Tumors in Women With Adnexal Masses

Abstract: The 4 RMI variants performed acceptably in a medium-resource setting where ultrasound examiners were physicians with varied experience. This finding indicates a good tradeoff between performance and feasibility, since ultrasound RMI protocols are of low complexity.

Cited by 20 publications

References 31 publications

Performance of the IOTA ADNEX model in preoperative discrimination of adnexal masses in a gynecological oncology center

Performance of the IOTA ADNEX model in preoperative discrimination of adnexal masses in a gynecological oncology center

Risk of Malignancy Index in Preoperative Evaluation of Adnexal Masses

Preoperative Differentiation Between Malignant and Benign Ovarian Masses in Patients with Normal CA-125 Levels

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