1. What is the RMI?

The Risk of Malignancy Index (RMI) is a scoring system used to estimate the risk of ovarian cancer in women with pelvic masses. It combines ultrasound findings, menopausal status, and CA125 levels.

2. How Does the Calculator Work?

The calculator uses the RMI formula:

Where:

• \( U \) — Ultrasound score (0-3)
• \( M \) — Menopausal status (1 for premenopausal, 3 for postmenopausal)
• \( CA125 \) — CA125 level in IU/mL

Explanation: The RMI helps differentiate between benign and malignant ovarian masses, with higher scores indicating greater risk of malignancy.

3. Importance of RMI Calculation

Details: RMI is crucial for triaging patients with adnexal masses, helping determine who should be referred to gynecologic oncologists for specialized care.

4. Using the Calculator

Tips: Enter ultrasound score (0-3), select menopausal status, and enter CA125 level in IU/mL. All values must be valid (CA125 > 0).

5. Frequently Asked Questions (FAQ)

Q1: What do different RMI scores mean?
A: Scores ≥200 suggest high risk of malignancy and warrant specialist referral. Scores <200 may indicate benign conditions.

Q2: How is the ultrasound score determined?
A: U=1 for each of: multilocular cyst, solid areas, metastases, ascites, bilateral lesions (max score 3).

Q3: What are normal CA125 values?
A: Normal is generally <35 IU/mL, but can be elevated in many benign conditions (endometriosis, PID, etc.).

Q4: Are there limitations to RMI?
A: Less accurate in premenopausal women and certain histologic subtypes. Not a definitive diagnostic tool.

Q5: Should RMI replace clinical judgment?
A: No, it should be used in conjunction with clinical assessment and other diagnostic modalities.