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    Patent Pending

    Risk of Malignancy Index (RMI) for Ovarian Cancer

    Predicts risk that an adnexal mass is malignant.
    Favorite
    Pearls/Pitfalls

    Requires CA-125 level to calculate, which may not otherwise be obtained.

    Ultrasound features
    No
    Yes
    No
    Yes
    No
    Yes
    No
    Yes
    No
    Yes
    Other features
    Premenopausal or perimenopausal
    Postmenopausal
    U/mL

    Result:

    Please fill out required fields.

    Next Steps
    Evidence
    Creator Insights

    Advice

    Consider further workup in patients with elevated RMI.

    Formula

    RMI = menopausal status x ultrasound score x serum CA-125, U/mL

    Where menopausal status and ultrasound score are as follows:

    Variable

    Points

    Ultrasound features

    Multiloculated cysts

    1 if 0-1 present

    3 if ≥2 present

    Solid areas

    Bilateral lesions

    Ascites

    Intra-abdominal metastases

    Menopausal status*

    Premenopausal or perimenopausal

    1

    Postmenopausal

    3

    *Postmenopausal status = >1 year of amenorrhea or age ≥50 years if patient is status post hysterectomy.

     

    Facts & Figures

    Interpretation:

    RMI

    Risk of malignancy

    ≤200

    Low

    >200

    High*

    *71% sensitive and 92% specific for ovarian cancer.

    Dr. Ian Jacobs

    About the Creator

    Ian Jacobs, BA, MA, MBBS, MD, FRCOG, is the president and vice chancellor of University of New South Wales in Sydney, Australia. He is also founder of both the Institute for Women's Health and the Ugandan Women's Health Initiative and former president of both the British Gynecological Cancer Society and the European Society of Gynecological Oncology. Dr. Jacobs' primary research is focused on risk stratification, screening, and prevention of gynecological cancer.

    To view Dr. Ian Jacobs's publications, visit PubMed