The Cardiovascular
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Risk of Malignancy Index (RMI) for Ovarian Cancer

Composite score for pre-operative risk of malignancy in an adnexal mass.

Risk of Malignancy Index (RMI) for Ovarian Cancer
Menopausal status
Ultrasound features (multilocular cyst, solid areas, bilaterality, ascites, intra-abdominal metastases)
Serum CA-125
U/mL
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When to use

  • Triaging a woman with an adnexal mass to general gynecology versus a specialist gynecologic-oncology service.

Formula

RMI = U x M x CA-125, where U is the ultrasound feature score (0, 1, or 3), M is the menopausal score (1 premenopausal, 3 postmenopausal), and CA-125 is in U/mL.

Pearls and pitfalls

  • Commonly used risk bands are <25 (low), 25-250 (moderate), and >250 (high), though exact cut-offs vary slightly by validation study.

References

  1. Jacobs I, et al. Br J Obstet Gynaecol. 1990;97(10):922-929.