Roma Index Ovarian Cancer Calculator

ROMA Equation:

For Premenopausal:
\[ PI = -12.0 + 2.38 \times \ln(HE4) + 0.0626 \times \ln(CA125) \] \[ ROMA\% = \frac{e^{PI}}{1 + e^{PI}} \times 100 \]
For Postmenopausal:
\[ PI = -8.09 + 1.04 \times \ln(HE4) + 0.732 \times \ln(CA125) \] \[ ROMA\% = \frac{e^{PI}}{1 + e^{PI}} \times 100 \]

ROMA Index:

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1. What is the ROMA Index?

The ROMA (Risk of Ovarian Malignancy Algorithm) index combines HE4 and CA125 biomarker levels with menopausal status to assess the risk of epithelial ovarian cancer. It helps differentiate between benign and malignant pelvic masses.

2. How Does the Calculator Work?

The calculator uses different ROMA equations based on menopausal status:

Where:

\( HE4 \) — Human epididymis protein 4 (pmol/L)
\( CA125 \) — Cancer antigen 125 (U/mL)
\( PI \) — Predictive index
Different coefficients for premenopausal and postmenopausal women

Explanation: The algorithm calculates a predictive index (PI) using natural logarithms of the biomarkers, then converts this to a percentage risk using logistic regression.

3. Importance of ROMA Index

Details: ROMA improves upon single-marker tests by combining two biomarkers with clinical status. It helps guide decisions about referral to gynecologic oncologists and further diagnostic testing.

4. Using the Calculator

Tips: Enter HE4 in pmol/L, CA125 in U/mL, and select menopausal status. Both biomarker values must be greater than zero.

5. Frequently Asked Questions (FAQ)

Q1: What are the cutoff values for ROMA?
A: Typically ≥11.4% (premenopausal) or ≥29.9% (postmenopausal) suggests high risk of epithelial ovarian cancer.

Q2: How does ROMA compare to RMI?
A: ROMA has similar sensitivity but higher specificity than RMI (Risk of Malignancy Index), especially in premenopausal women.

Q3: When should ROMA be used?
A: For women with pelvic mass suspicious for ovarian cancer, prior to surgery or other invasive procedures.

Q4: What are limitations of ROMA?
A: Not validated in women <18 years, with non-ovarian cancers, or those already receiving cancer treatment.

Q5: Can ROMA diagnose ovarian cancer?
A: No, it's a risk assessment tool. Definitive diagnosis requires histopathological examination.