Ultrasonographic Scoring and Risk of Malignancy Index in Preoperative Prediction of Ovarian Malignancy

Abstract

Abstract

Background: Recently Ferrazi et al. proposed a simple ultrasonographic (USG) scoring system to predict malignancy in adnexal masses and this system was claimed to be as accurate as combined methods of prediction, such as the risk of malignancy index 2 (RMI 2). Objective: The aim of this research was to compare the RMI 2 with the USG scoring method (Ferrazi scoring) for predicting ovarian malignancy preoperatively. Design: This was a prospective observational study. Materials and Methods: Conducted between July 2007 at May 2009 at the Jawaharlal Institute of Postgraduate Education and Research, in Puducherry, India, the study included 113 subjects with ovarian masses and excluded patients with recurrent ovarian masses and those associated with pregnancy. RMI 2 was determined per Tingulstad and collegues, and USG score was assessed transabdominally as described by Ferrazi et al. Statistical analysis was done by plotting receiver operative curves to determine the best score cutoff values. The Mann-Whitney U-test was used to compare the scores. Results: The best performance of RMI 2 was at a cutoff level of 100, with a specificity of 84%, a sensitivity of 56%, and a negative predictive value (NPV) of 92%. A Ferrazi score of 8 was found to have a sensitivity of 81%, a specificity of 82%, and a NPV of 96%. Conclusions: The Ferrazi method of scoring was found to be a better predictor of malignancy, compared to the RMI 2 method (p<0.0001), and the Ferazzi method is simple, fast, and inexpensive. (J GYNECOL SURG 29:61)