Objective: The aim of this study was to evaluate the use of risk of malignancy index (RMI) based on a serumCA125 level, ultrasound findings and menopausal status in primary evaluation of patients with adnexal massesin daily clinical practice. Methods: One hundred and fifty one women with adnexal masses were enrolled.Ultrasound characteristics, menopausal status and serum CA125 level were documented preoperatively, andcombined into the RMI afterwards. The sensitivity, specificity, positive (PPV) and negative predictive values(NPV) of the RMI in prediction of ovarian cancer were calculated. Results: The RMI identified malignant casesmore accurately than any individual criterion in diagnosing ovarian cancer. Using a cut-off level of 238 to indicatemalignancy, the RMI showed a sensitivity of 89.5%, a specificity of 96.2%, a PPV of 77.3%, a NPV of 98.4%and an accuracy of 95.4%. Conclusion: RMI is a simple, easily applicable method in the primary evaluation ofpatients with adnexal masses of high risk of malignancy, resulting in timely referal to gynecological oncologycenters for suitable surgical operations.
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