Risk of malignancy index 4 in preoperative evaluation of patients with ovarian tumours

Singhal, Sunita; Rajoria, Lata; Mital, Premlata; Batar, Alka; Ainani, Richa; Agarwal, Monika; Urmila, .; Chaudhary, Kavita

doi:10.18203/2320-1770.ijrcog20182370

Cited by 6 publications

(9 citation statements)

References 12 publications

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“…The receiver operating curve for USG score in our study was 0.93. [20] Our results were similar to B.R Obeidat et al i.e area under curve 0.73. [18] Evaluation of Logistic regression analysis with histopathological diagnosis as a constant value, the only parameter i.e USG score can individually diagnose and differentiate benign from malignant adnexal masses (p value -0.0001).…”

Section: Discussionsupporting

confidence: 92%

“…[19] Recent study by 2018 Singhal S et al gave a sensitivity of 75% and specificity of 90% for CA-125 levels >35U/ml. [20] The best cut off value of CA-125 was 50 U/ml with a sensitivity of 87.3% and specificity of 93.5% in our study. [3] Analysis of 132 patients with ultrasound features in respect of benign and malignant patients are as follows.…”

Section: Discussionsupporting

confidence: 47%

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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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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 47%

Risk of Malignancy Index in Preoperative Evaluation of Adnexal Masses

A¹,

Jajoo²

2018

jemds

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“…15 Recent study by 2018 Singhal S et al gave a sensitivity of 75% and specificity of 90% for CA-125 levels > 35U/ml. 19 In our study, CA125 levels ≥ 35 U/ml had a sensitivity of 75.6%, the specificity of only 48.2%, PPV 43.6% and NPV of 78.8%. A higher prevalence of pelvic inflammatory diseases and endometriosis might have contributed to elevated CA125 levels in the majority of our patients along with fluctuation of CA125 during the menstrual cycles in premenopausal patients with adnexal masses and its more specificity for non-mucinous epithelial ovarian tumor might be the reason for its low diagnostic performance in the detection of malignant ovarian disease.…”

Section: Discussioncontrasting

confidence: 43%

Evaluation of risk of malignancy index in adnexal masses at a tertiary hospital: a prospective study

Behera

Pradhan

Misra

2020

Int J Reprod Contracept Obstet Gynecol

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Background: The discrimination between benign and malignant adnexal masses is important in deciding clinical management and optimal surgical planning. The aim of the study was to evaluate the effectiveness of risk of malignancy index (RMI) to identify cases with high potential of ovarian malignancy at a tertiary hospital.Methods: This prospective study was conducted over a period of two years from September 2017 to August 2019 at obstetrics and gynecology department of M. K. C. G. Medical College and Hospital, Berhampur. A total case of 130 patients with adnexal masses who underwent surgical treatment were included as histopathological report was taken as gold standard to calculate accuracy of RMI.Results: Of the total masses, 85 (65.4%) were benign and 45 (34.6%) were malignant. The mean age of patients was 41.03±14 years. The best cut off value for the RMI-3 was 225 with highest area under the ROC curve 87%, sensitivity of 75.55%, specificity of 98.82%, PPV of 97.14%, NPV of 88.42% and an accuracy of 90.76%.Conclusions: The present study demonstrated that RMI was a reliable method in detecting malignant ovarian tumors. The RMI is a simple and practically applicable tool in preoperative discrimination between benign and malignant adnexal masses in non-specialized gynecologic departments, particularly in developing countries.

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“…Simsek et al reported a sensitivity of 78.6% and specificity of 63.5% for CA 125 at a cutoff value of 35 u/ml [ 10 ]. In a recent study, Singhal et al found a sensitivity of 75% and specificity of 90% for CA 125 levels > 35 u/ml [ 13 ]. Meanwhile, in this study, three out of 136 patients were malignant with CA 125 < 35 u/ml and 28 out of 55 were malignant with CA 125 > 35 u/ml (Table 2 ).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Four Risk of Malignancy Indices for Preoperative Evaluation of Ovarian Masses: A Prospective Observational Study

Priyanka¹,

Panda²,

Samantroy³

et al. 2023

Cureus

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Background: Ovarian cancer imposes a significant health burden worldwide. Although various tumor markers are available to diagnose ovarian cancer, low-resource countries like India require a humble marker or index. The Risk of Malignancy Index (RMI) has been found to be a simple yet promising tool that can be used for this purpose. In this study, we attempted to validate various RMIs with the help of menopausal status, ultrasonogram score, cancer antigen (CA) 125 value and compare all four RMIs, which would be useful to differentiate benign and malignant ovarian masses. This could be an essential tool, especially in lowresource settings.Method: This prospective study was conducted at Kalinga Institute of Medical Sciences in Odisha, India, from September 2020 to September 2022 involving 191 patients with ovarian mass with histopathology, which was deemed the "gold standard" diagnostic tool. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of RMI 1, 2, 3, and 4 were calculated and compared.Results: Out of 191 patients, 32 (16%) had malignancy and 159 (83.2%) had benign pathology. It was apparent that RMI 4 was a better tool for the initial assessment of patients with ovarian masses with a sensitivity of 80.6%, specificity of 96.2%, PPV of 81%, NPV of 96% at a cutoff of 334, and an area under the curve value of 0.939. Conclusion: RMI 4 followed by RMI 3 were relatively better indices than RMI 1 and RMI 2 for identifying benign and malignant ovarian masses. RMI 4 was a valuable and applicable method in diagnosing pelvic masses with a high risk of malignancy.

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Risk of malignancy index 4 in preoperative evaluation of patients with ovarian tumours

Cited by 6 publications

References 12 publications

Risk of Malignancy Index in Preoperative Evaluation of Adnexal Masses

Risk of Malignancy Index in Preoperative Evaluation of Adnexal Masses

Evaluation of risk of malignancy index in adnexal masses at a tertiary hospital: a prospective study

Comparison of Four Risk of Malignancy Indices for Preoperative Evaluation of Ovarian Masses: A Prospective Observational Study

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