Comparing the Diagnostic Value of the Risk of Ovarian Malignancy Algorithm (ROMA) and Risk of Malignancy Index (RMI) in Women with an Adnexal Mass

In: Indian Journal of Gynecologic Oncology · 2021 · vol. 19(4) · doi:10.1007/s40944-021-00514-y · W3174832123
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This study compared the diagnostic value of ROMA and RMI in women with adnexal masses and found ROMA to be more sensitive for diagnosing ovarian cancer, particularly in postmenopausal patients.

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This cross-sectional study evaluated the diagnostic performance of the Risk of Ovarian Malignancy Algorithm (ROMA) and the Risk of Malignancy Index (RMI) in 245 women presenting with adnexal masses. By measuring serum HE4 and CA-125 levels alongside ultrasound findings, the researchers calculated malignancy probabilities for both indices prior to surgical intervention and pathological confirmation. The results indicated that ROMA demonstrated superior sensitivity compared to RMI for diagnosing ovarian cancer, borderline tumors, and endometriosis, particularly in postmenopausal patients. Relevance to endometriosis: Endometriosis is explicitly listed as one of the conditions for which ROMA showed higher sensitivity than RMI, although the paper's primary focus remains on differentiating malignant from benign ovarian pathology.

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Abstract

Purpose Ovarian cancer is the fifth leading cause of cancer death among women worldwide. This study aimed to compare the diagnostic value of the risk of ovarian malignancy algorithm (ROMA) and risk of malignancy index (RMI) in women with an adnexal mass.

Methods

This cross-sectional study investigated 245 patients with adnexal mass in Afzalipour Hospital, Kerman, Iran, from 2016 to 2017. Before surgery, 10 cc of blood was taken from each patient. Tumor markers were measured using luminescence immunochemistry with HE4 and CA-125 kits. After surgery, tissue samples were sent to a medical diagnostic laboratory. World Health Organization criteria were applied for pathological classification. Based on CA-125 and HE4 levels and ultrasound findings and menopausal status of patients, ROMA and RMI were used to calculate the malignancy probability in each patient.

Results

The average age of cases was 40.88 ± 14 years. Most tumors were benign (45%). The rate of mass metastasis was 2%. The mean levels of HE4 and CA-125 were 117.52 ± 161.49 and 160.945 ± 302.49, respectively. ROMA was more sensitive than RMI for diagnosis of malignancies, borderline and endometriosis. ROMA was of higher sensitivity and specificity for diagnosis of ovarian cancer in postmenopausal patients. Both ROMA and RMI were of higher sensitivity, specificity, positive and negative predictive values for diagnosis of malignancies.

Conclusion

ROMA is more sensitive than RMI for the diagnosis of ovarian cancer. Accordingly, it can be applied as an appropriate method for diagnosing ovarian cancer as well as for treatment decisions in gynecological surgery wards. Similar content being viewed by others

References

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Acknowledgements

The authors thank the staff and participants of this study for their important contributions. Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors. Author information Authors and Affiliations Corresponding author Ethics declarations Conflict of interests The authors declare that they have no conflict of interests. Consent to participate Informed consent was taken from all patients. Ethics approval This study was approved by the Ethics Committee of Kerman University of Medical Sciences in Iran (Ethical Code: IR.KMU. AH.REC.1396.1553). Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions About this article Cite this article Honarvar, Z., Monshi, M. & Karami Robati, F. Comparing the Diagnostic Value of the Risk of Ovarian Malignancy Algorithm (ROMA) and Risk of Malignancy Index (RMI) in Women with an Adnexal Mass. Indian J Gynecol Oncolog 19, 56 (2021). https://doi.org/10.1007/s40944-021-00514-y Received: Revised: Accepted: Published: Version of record: DOI: https://doi.org/10.1007/s40944-021-00514-y

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