RMI Score: Risk of Malignancy Index
Calculate the RMI score to assess the risk of malignancy in ovarian masses. Official criteria.
The RMI Score: Evaluating Ovarian Masses
The Risk of Malignancy Index (RMI), developed by Jacobs et al. in 1990, is a widely used clinical tool in gynecology to assess the probability that an adnexal mass is an ovarian cancer.
How does the RMI score work?
The RMI score is the mathematical product of three simple variables (RMI = U x M x CA125):
- (U) Ultrasound Score: Evaluates 5 suspicious features. 0 signs = U(0); 1 sign = U(1); ≥2 signs = U(3).
- (M) Menopausal Status: Premenopausal (M=1). Post-menopausal (M=3).
- (CA 125): The absolute serum level of the CA 125 tumor marker, in U/mL.
Clinical Guidelines
An RMI score > 200 has a sensitivity of approximately 85% and a specificity of 97% for predicting ovarian cancer. Patients with a high score (> 200) must be referred to a specialized gynecologic oncology center for optimal surgical management.
Risk Stratification
| RMI Score | Risk of Malignancy | Recommendation |
|---|---|---|
| < 200 | Low Risk (~3%) | Follow-up or local surgery (laparoscopy). |
| ≥ 200 | High Risk (~75%) | Referral to oncology center. |
References:
1. Jacobs I, Oram D, Fairbanks J, et al. A risk of malignancy index incorporating CA 125, ultrasound and menopausal status for the accurate preoperative diagnosis of ovarian cancer. Br J Obstet Gynaecol. 1990;97(10):922-929.
[PubMed]
2. RCOG. The Management of Suspected Ovarian Masses in Premenopausal Women. Green-top Guideline No. 62.
[RCOG Official]
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