J Korean Soc Menopause.  2013 Apr;19(1):18-25. 10.6118/jksm.2013.19.1.18.

Discrimination between Benign and Malignant Pelvic Masses Using the Risk of Malignancy Index 1

• Park JW
• Hwang SO
• Park JH
• Lee BI
• Lee JH
• Kim KW
• Kim KM
• Jung MJ
• Yun NR
• Song E

• KMID: 1768793
• DOI: http://doi.org/10.6118/jksm.2013.19.1.18

Abstract

OBJECTIVES
To assess the ability of risk of malignancy index (RMI) 1 to discriminate between benign and malignant pelvic masses.
METHODS
Between January 2007 and December 2010, 547 women with pelvic masses were evaluated. Their medical records are reviewed here retrospectively. The sensitivity, specificity and positive and negative predictive values of the cancer antigen (CA) 125 level, ultrasound findings and menopausal status in the prediction of malignant pelvic masses were calculated and compared individually or combined using the RMI 1.
RESULTS
The receiver operating characteristic (ROC) curves of CA 125, the ultrasound score and the RMI 1 were all found to be relevant predictors of malignancy. ROC analysis of the RMI 1, CA 125 serum levels, ultrasound score and menopausal status showed areas under the curves of 0.795, 0.782, 0.784 and 0.594, respectively. The RMI 1 was found to be statistically significantly correlated with menopausal status (P = 0.001), while not statistically significantly correlated with CA 125 (P = 0.628) or the ultrasound score (P = 0.541). The RMI 1 at a cut-off of 150 - with a sensitivity of 77.9%, specificity of 81.1%, positive predictive value of 51.7% and negative predictive value of 93.4% - showed the highest performance in determining the malignant tendency of pelvic masses.
CONCLUSION
Accepting a RMI 1 cut-off value of 150 results in statistically more significant diagnostic criteria than menopausal status for the discrimination of benign and malignant pelvic masses.

Keyword

Pelvic mass; Risk of malignancy index

MeSH Terms

Discrimination (Psychology)
Female
Humans
Medical Records
Retrospective Studies
ROC Curve
Sensitivity and Specificity

Figure

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  Fig. 1 Receiver operating characteristic (ROC) curves of individual predictors showing the relationship between sensitivity and specificity of menopause score, ultrasound score, serum cancer antigen (CA) 125 level and the risk of malignancy index (RMI) 1 in the discrimination between benign and malignant pelvic masses.

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