Comparative Analysis of Two Risk of Malignancy Indices (RMI) in the Accurate Detection of Pre-Operative Malignant/Benign Ovarian Masses

Abstract

Background: Any pelvic/ovarian mass, whether unilateral or bilateral, is one of the leading indications in OPD for sending a patient to gynecologists. However, these gynecological masses often are benign and may or may not require surgical excision. Almost 24% of pelvic tumors in women of reproductive age group are malignant and in Postmenopausal up to 60% are malignant.

Objective: The study was aimed at comparative analysis of accuracy of two different RMI indices ( i.e. RMI- 2 & RMI-3) in the pre-operative detection of malignant ovarian masses in females of all ages.

Methods: This prospective study intended to include 75 women who got 1^st admission to the Gynecology Department of Lady Willingdon Hospital for the evaluation and management of pelvic or ovarian masses. To differentiate between malignant and benign ovarian tumors, their sensitivity, their specificity, Positive and Negative predictive values and the ability to diagnose accurately of two RMIs (RMI 2 and RMI 3) was ascertained.

Results: Study findings reveal no mathematically significant difference in the results of the two different Risk of Malignancy Indices (RMIs) when assessing for malignancy. Nevertheless, it is noteworthy that RMIs emerged as more reliable tools in detection compared to relying solely on blood CA-125 levels, if female is pre or post-menopausal, or certain ultrasound features and size of the tumor in isolation for identifying malignant ovarian masses.

Conclusion: It can be summed up that any of the two RMIs described in this study can be applied for evaluation of patients for appropriate therapy. This method of RMI is a simple basic technique and it can be used anywhere, in less-equipped gyne departments to help the doctor in the establishing the nature of cases for referral to an oncology department or hospital.