1. What is the Risk of Malignancy Index (RMI)?

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

2. How Does the Calculator Work?

The calculator uses the RMI equation:

Where:

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

Interpretation:

• RMI < 25: Low risk of malignancy
• RMI 25-200: Moderate risk of malignancy
• RMI > 200: High risk of malignancy

3. Importance of RMI Calculation

Details: RMI helps guide clinical decision-making for women with adnexal masses, determining whether referral to a gynecologic oncologist is appropriate and assisting in surgical planning.

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 ultrasound features are scored in RMI?
A: Multilocular cysts, solid areas, bilateral lesions, ascites, and intra-abdominal metastases (1 point each, maximum score of 3).

Q2: How accurate is RMI for predicting ovarian cancer?
A: RMI has a sensitivity of 78-80% and specificity of 85-92% for detecting ovarian malignancy.

Q3: Are there limitations to RMI?
A: RMI may be less accurate in premenopausal women and those with borderline tumors. It doesn't account for other tumor markers.

Q4: What are the clinical implications of RMI?
A: Women with RMI > 200 should be referred to a gynecologic oncologist for specialized care.

Q5: Are there alternative scoring systems?
A: Yes, alternatives include ROMA (Risk of Ovarian Malignancy Algorithm) and IOTA (International Ovarian Tumor Analysis) models.