Qurratulain Mushtaq, Mona Zafar, Sarwat Navid.
Accuracy of risk of malignancy index in preoperative evaluation of adnexal masses.
Pak Armed Forces Med J Jan ;64(4):528-32.

Objectives: To evaluate the diagnostic accuracy of Risk of Malignancy Index (RMI) in discriminating between benign and malignant adnexal masses taking histopathology as the gold standard. Study Design: Validation study. Place and Duration of Study: The study was done at the department of Obstetrics & Gynaecology, Government Lady Aitchison Hospital, Lahore from January 2009 to July 2009. Patients and Methods: Total 60 patients were included in this study. Risk-of-malignancy Index level (RMI) < 200 was taken as benign and RMI >200 was taken as malignant. Histopathology report was followed after surgery. Results: Mean age of the patients was found to be 41.03 ± 8.59 years. The results of RMI were compared with the histopathology with report at histopathology, 91.7% patients had benign masses and 8.3% patients had malignant masses. At RMI, 88.3% patients had benign masses and 11.7% patients had malignant masses. While RMI findings were confirmed with diagnosis made on histopathology the sensitivity, specificity and diagnostic accuracy were found to be 100%, 96.3%, 96.6%, respectively. Positive and negative predictive values of RMI were 71.4%, and 100%, respectively. Conclusion: RMI is an appropriate tool for diagnosing adnexal masses with high risk of malignancy and referring to specialist gynecological centers for suitable surgical operations.

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