Kiran Abhijit Kulkarni1, Premalatha T. S2, Geeta Acharya3, Julian Crasta4, Sumithra Selvam5, Elizabeth Vallikad6
CONTEXT
Preoperative assessment of adnexal mass aids in appropriate referral and in planning optimal surgery. The risk of malignancy index (RMI) has been shown to be a triage tool for the same.
AIMS
This study aimed to evaluate the ability of risk of malignancy risk index 4 (RMI 4) in preoperatively predicting the nature of an adnexal mass and to compare it with risk of malignancy index 2 (RMI 2).
SETTINGS AND DESIGN
A retrospective study was carried out in 71 women with an adnexal mass requiring operative intervention attending a tertiary care hospital.
METHODS AND MATERIAL
Risk of malignancy indices were calculated based on ultrasound score, menopausal status, serum CA-125 levels and size of the tumour. Histopathological report of the tumour was considered as gold standard.
STATISTICAL ANALYSIS
T test, McNemar’s test, Mann-Whitney U test and kappa analysis were used to analyse the data. A p value of < 0.05 was considered significant.
RESULTS
Thirty nine of 71 specimens were malignant. RMI 4 had a sensitivity and specificity of 79% and 81% respectively. RMI 2 had a sensitivity and specificity of 82% and 78% respectively. Measurement of agreement between RMI 2 and RMI 4 was 96%.
CONCLUSIONS
RMI 4 was a good tool with a balanced sensitivity and specificity. However, RMI 2 was marginally more sensitive among the indices studied; however, less specific than RMI 4.
