Background: Ovarian neoplasms can be benign or malignant and accurate preoperative diagnosis is crucial for determining the appropriate surgical approach. Risk of malignancy index (RMI 4) is a useful tool that combines radiological findings, CA-125 levels, and tumor size to predict the likelihood of malignancy. The RMI 4 score is interpreted as either <450 or >450 and compared to the final histopathology report.
Aim and Objectives: The aim of this study is to evaluate the accuracy of RMI 4 in predicting the risk of malignancy in early ovarian neoplasms and to investigate its association with histopathological findings. The specific objectives are:
1) To determine the sensitivity of RMI 4 in predicting malignancy in suspected early ovarian neoplasms.
2) To compare the sensitivity of RMI 4 with CA-125 levels in predicting malignancy.
3) To examine the association between RMI 4 score and final histopathological examination findings.
Methods: This cross-sectional study was conducted in the Oncology OPD of ALLURI SITA RAMA RAJU ACADEMY OF MEDICAL SCIENCES (ASRAM) over a period of one year, from February 2021 to January 2022. We included 46 patients who met the inclusion criteria.
Results: The sensitivity of RMI 4 in predicting malignancy was found to be 52.4% for all cases, while it was 84.6% for serous and mucinous tumors. The sensitivity of CA-125 was 61.9% for all cases and 84.6% for serous and mucinous tumors. Our study found that RMI 4 and CA-125 are more predictive of malignancy in serous tumors compared to mucinous and other pathologies.
Conclusion: In conclusion, RMI 4 is a useful tool for differentiating malignant from benign ovarian lesions. Our study shows that RMI 4 and CA-125 are more sensitive in predicting malignancy in serous tumors compared to mucinous and other pathologies. Clinicians can use these tools to guide the appropriate surgical approach and improve patient outcomes.
