Comparing Four Different Risk Malignancy Indices in Differentiating Benign and Malignant Ovarian Masses

Area of Science:

• Gynecologic Oncology
• Radiology
• Pathology

Background:

• Accurate preoperative assessment of ovarian masses is vital for effective ovarian cancer management.
• Distinguishing benign from malignant ovarian masses preoperatively influences treatment strategies.

Purpose of the Study:

• To evaluate the diagnostic performance of four different risk of malignancy index (RMI) calculations.
• To assess the utility of RMI incorporating menopausal status, CA-125, and imaging for preoperative differentiation of ovarian masses.

Main Methods:

• Prospective evaluation of 121 women with ovarian masses from August 2018 to January 2020.
• Calculation of four RMI variations (RMI 1-4) using clinical, biochemical, and imaging data.
• Histopathological diagnosis served as the gold standard; diagnostic accuracy was assessed using ROC curve analysis.

Main Results:

• Benign, malignant, and borderline tumors were found in 50.4%, 40.49%, and 9.09% of cases, respectively.
• Sensitivities for RMI 1-4 were 77.0%, 63.0%, 77.0%, and 77.0%; specificities were 84.0%, 86.0%, 77.0%, and 71.0%.
• RMI 2 exhibited the highest specificity (86.0%), while RMI 1 showed the highest diagnostic accuracy.

Conclusions:

• The risk of malignancy index (RMI) is a valuable, cost-effective tool for preoperative differentiation of ovarian masses.
• Specific RMI variations offer distinct advantages in sensitivity and specificity for identifying ovarian malignancy.