Comparative performance of four risk of malignancy indices (RMI) in predicting ovarian malignancy: a large retrospective cohort study
Ginekologia Polska, cilt.97, sa.7, ss.550-555, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 97 Sayı: 7
- Basım Tarihi: 2026
- Doi Numarası: 10.5603/gpl.109129
- Dergi Adı: Ginekologia Polska
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Central & Eastern European Academic Source (CEEAS), Directory of Open Access Journals, Health Research Premium Collection (ProQuest)
- Sayfa Sayıları: ss.550-555
- Anahtar Kelimeler: adnexal mass, ovarian cancer, risk of malignancy index, ultrasonography
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Ankara Yıldırım Beyazıt Üniversitesi Adresli: Hayır
Özet
Objectives: To compare the predictive performance of four risk of malignancy index (RMI) in patients with adnexal masses. Material and methods: This retrospective study included 703 patients who underwent surgery for adnexal masses. Pre-operative ultrasonographic findings, menopausal status, and serum CA-125 levels were used to calculate RMI-1, -2, -3, and -4. Histopathology served as the reference standard. Sensitivity, specificity, positive and negative predictive values, and overall accuracy were analyzed. Results: Among 703 patients, 77.2% had benign lesions, 3.3% borderline tumors, and 19.5% malignant disease. RMI-1 demonstrated: Sensitivity: 74.4%, Specificity: 91.3%, PPV: 71.7%, NPV: 92.4%. RMI-2 demonstrated: Sensitivity: 80.6%, Specificity: 86.2%, PPV: 63.2%, NPV: 93.8%. RMI-3 demonstrated: Sensitivity: 75.6%, Specificity: 90.1%, PPV: 69.1%, NPV: 92.6%. RMI-4 demonstrated: Sensitivity: 78.8%, Specificity: 89.9%, PPV: 69.6%, NPV: 93.5%. ROC analysis showed areas under the curve of 0.900, 0.896, 0.893, and 0.893 for RMI-1 to RMI-4, respectively. RMI-1 had the highest specificity and overall accuracy, whereas RMI-2 achieved the highest sensitivity. Pairwise comparisons revealed statistically significant differences among RMIs. Conclusions: All four RMIs effectively differentiate benign from malignant adnexal masses. RMI-1 offers the highest overall accuracy and specificity, and RMI-2 the highest sensitivity. These indices provide valuable preoperative risk stratification to guide clinical management and referral to specialized care. Institutional resources should inform the choice of RMI.