Risk of Malignancy Index Assessment in Pre and Postmenopausal Women with Adnexal Masses: A Cross-Sectional Study

Background: Adnexal mass is a common presentation in gynecological settings. Differentiation between benign and malignant tumors is crucial for deciding the proper place and type of treatment. The RMI is considered a good and reliable tool in pre-operative differentiation of ovarian tumors, but limited work has been done on this tool in low-resource settings. Objective: To assess the diagnostic accuracy of Risk of malignancy index in differentiating benign from malignant ovarian tumors. Methods: This cross-sectional study was conducted in Department of Obstetrics & Gynaecology at a Teaching Hospital, Lahore. Eighty females between 30-80 years, admitted with adnexal mass in the Department of Obstetrics & Gynaecology at Central Park Teaching Hospital, Lahore from October 1st to 30th September, 2023 were enrolled. RMI was calculated and findings were compared with histopathology. Results: Among enrolled 80 females with adnexal mass the mean age of females was 43.70 ± 8.21 years. The mean BMI was 30.60 ± 5.68 kg/m2. The mean duration of post-menopausal bleeding was 14.50 ± 6.22 months. The mean RMI of females was 212.95 ± 159.76. The Sensitivity of RMI was 100%, specificity was 90.6%, PPV was 72.7%, NPV was 100%, and diagnostic accuracy was 92.5% taking histopathological findings as gold standard. Conclusion: Thus, RMI is found to be a reliable tool for the diagnosis of ovarian malignancy in females with suspicious adnexal mass.