title: Risk of malignancy index in the evaluation of patients with adnexal masses.
abstract: OBJECTIVE
  To determine if the risk of malignancy index (RMI) can distinguish between benign and malignant adnexal masses in a population of women referred to a department of gynaecologic oncology for surgical resection of an adnexal mass.
  
  
  METHODS
  We performed a retrospective review of the medical of charts of 259 consecutive patients. Ninety-six charts did not have data available to calculate the RMI, leaving a total of 163 for review. Three definitions of RMI were compared; each incorporated menopausal status of the patient, ultrasound characteristics of the adnexal mass, and serum CA-125 level.
  
  
  RESULTS
  Of the masses resected, 105 were benign and 58 were malignant. The area under the ROC curve for all three definitions of RMI was 0.87. Using a cut-off of 120, the first RMI definition (RMI 1) had a sensitivity of 72% and a specificity of 87%; the second (RMI 2) had a sensitivity of 76% and a specificity of 81%; and the third (RMI 3) had a sensitivity of 74% and a specificity of 84%. These results are generally in agreement with published values.
  
  
  CONCLUSIONS
  We have validated the use of RMI to predict the risk of malignancy in a Nova Scotia population of women with adnexal masses. This will aid in more selective referral of patients to specialized oncology centres for cancer surgery, allowing for appropriate management of health care resources and optimization of treatment for women with gynaecological malignancies.
authors: Department of Diagnostic Radiology, Dalhousie University, Halifax NS.
authors: Sharon E
authors: SE
authors: Clarke
authors: Robert
authors: R
authors: Grimshaw
authors: Paula
authors: P
authors: Rittenberg
authors: Katharina
authors: K
authors: Kieser
authors: James
authors: J
authors: Bentley
mesh_terms: D000291:Adnexal Diseases / Q000175:diagnosis*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018394:CA-125 Antigen / Q000032:analysis; D005260:Female; D005833:Genital Neoplasms, Female / Q000175:diagnosis*; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D018394:CA-125 Antigen