Correlation between risk of malignancy index and histopathological findings in ovarian tumors

Ovarian tumors are one of the most frequent gynecological issues. According to Globocan death projections for 2022, more than 8 million women are predicted to lose their lives to ovarian cancer globally. The risk of malignancy index (RMI) is derived from the product of the ultrasonographic (USG) score (U), menopausal status score (M), and serum CA-125 value. It is an effective technique for diagnosing ovarian malignancy. The aim of the study was to determine the diagnostic accuracy of RMI 3 in ovarian tumors.

This was a prospective observational study and was carried out in the Obstetrics and Gynecology Department over the course of 1 year. In total, 86 patients were enrolled in the study. Patient underwent all routine investigations, including ultrasound whole abdomen and CA-125. RMI 3 was calculated. All the patients underwent laparotomy. The histopathological report of the ovarian tumors was analyzed for correlation with the RMI score.

In our study, maximum number of patients were pre-menopausal (65 (75.6%)) and multiparous (61.6% (53/86)). The RMI score (cutoff at 225 by receiver-operator characteristic curve) had the highest specificity at 90.6% and positive predictive value at 70.0%, while the USG score had the highest sensitivity at 86.4% and negative predictive value at 94.6%. Both the RMI score (cutoff at 225) and the USG score had similar diagnostic accuracy of 83.7%.

This study concluded that RMI is an effective technique for diagnosing ovarian tumors with a high probability of malignancy than individual indicators such as CA-125, menopausal score, and ultrasound score. It will help in timely referral of patients to gynecological oncology centers for their optimal surgical management.