Publication:

A prospective cross-sectional observational study to compare the predictive performance of four types of risk malignancy index and computed tomography and magnetic resonance imaging findings in the triage of adnexal masses at a tertiary care centre in Mumbai, India

Background Accurate pre-operative differentiation between benign and malignant adnexal masses is essential for appropriate referral and management.

Methods A prospective cross-sectional observational study was conducted from August 2023 to July 2024 in the Department of Obstetrics and Gynaecology, Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai. Sixty women with adnexal masses were evaluated using clinical parameters, ultrasound, CA-125, and four types of risk of malignancy indices (RMI I-IV). Computed tomography and magnetic resonance imaging (CT/MRI) findings were compared wherever available. Histopathology served as the gold standard.

Results Mean age 37.4±10.4 years. Of 60 cases, 45 (75%) benign, 15 (25%) malignant. RMI IV had highest diagnostic accuracy area under the curve (AUC=0.892). CT showed 100% sensitivity and 94.4% specificity.

Conclusions RMI IV is the most reliable index for differentiating benign and malignant adnexal masses. CT provides additional diagnostic accuracy and is recommended for equivocal cases.