Journal of Korean Society of Ultrasound in Medicine 2010;29(3): 157-164.
Comparison of the Usefulness of four Risk-of-Malignancy Indices using Ultrasonography in Ovarian masses.
Moo Sung Jo, Su Hyun Moon, Jong Kil Joo, Dong Soo Suh, Ki Hyung Kim, Man Soo Yoon
Department of Obstetrics and Gynecology, Pusan National University School of Medicine, Busan, Korea.
  Published online: September 1, 2010.
PURPOSE: The aim of this study was to evaluate the usefulness of four Risk-of-Malignancy Indices (RMI) in women with ovarian masses. MATERIALS AND METHODS: Between January 2007 and December 2008, 344 women who visited our hospital for surgical exploration due to an ovarian mass were enrolled in this study. Each RMI was based on the combination of menopausal status, ultrasound findings of ovarian masses, and absolute level of serum CA-125. A cutoff level of 200 was chosen as the threshold for determining between malignant and benign ovarian masses in RMI 1, RMI 2, and RMI 3. A cutoff level of 450 was chosen as the threshold in RMI 4. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were determined. RESULTS: The combination of four malignancy indices is more accurate than menopausal status, ultrasound findings, and serum CA-125 alone, respectively for determining whether a mass is benign or malignant. RMI 1 and RMI 4 were found to be better than RMI 2 and RMI 3. RMI 4 was the most reliable test among them. The relationship between RMI 1 and RMI 4 was not statistically significant. With the cutoff level for RMI 4 at 450, the corresponding, sensitivity, specificity, positive predictive value, and negative predictive value were 72.1%, 88.0%, 56.4%, 93.9%, respectively. CONCLUSION: All four RMI were reliable tests for determining whether ovarian masses are malignant or benign, and RMI 4 was the most reliable index among them.
Keywords: Ovarian masses; Risk of malignancy index
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