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Clinical calculator summary

RMI (Risk of Malignancy Index)

The Risk of Malignancy Index (RMI I) is a widely used algorithm to assess the likelihood that an adnexal mass is malignant (ovarian cancer).

Evidence-based context for fast calculator use

Purpose:
Risk of Malignancy Index estimates ovarian cancer probability in adnexal masses using CA125, ultrasound, and menopausal status for triage.
Population:
patients undergoing ovarian, cervical, endometrial, or gestational-trophoblastic risk and staging assessment
Factors:
Menopausal Status, Serum CA125, Ultrasound Features
Reference:
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.
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RMI (Risk of Malignancy Index)

Clinical Context & Background

The Risk of Malignancy Index (RMI I) is a widely used algorithm to assess the likelihood that an adnexal mass is malignant (ovarian cancer). It combines serum CA125, menopausal status, and ultrasound features. An RMI > 200 suggests high risk and referral to a gynecologic oncologist.
Primary Source EvidenceJacobs 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.
Formula Logic
RMI = U x M x CA125

Reference Data

RMI ScoreRisk PredictionManagement
< 25Low Risk (<3%)Conservative / General Gyn
25 - 200Intermediate Risk (~20%)Further imaging / Specialist review
> 200High Risk (>75%)Referral to Gyn Oncologist

Clinical Workflow

Use, Interpret, And Continue The Patient Pathway

Expand for workflow guidance, limitations, examples, and related next steps.

When To Use

  • Use RMI (Risk of Malignancy Index) when risk of Malignancy Index estimates ovarian cancer probability in adnexal masses using CA125, ultrasound, and menopausal status for triage.
  • Confirm that the patient, diagnosis, disease phase, and available inputs match the cited model before calculation.

How To Interpret

  • Interpret the displayed result using the calculator-specific formula and reference table, spanning < 25 through > 200.
  • A boundary result should prompt input verification and clinical review rather than false precision.

What To Do Next

  • Confirm organ site, pathology, menopausal or postoperative context, imaging, biomarker assay, and specialist referral pathway.
  • Document the inputs, result, timing, and clinical context so the assessment can be reproduced.

Limitations

  • Adnexal-mass, cervical postoperative, endometrial, and ovarian cytoreduction models answer different clinical questions.
  • The result supports clinician judgment and does not independently determine treatment.

Validated Population

patients undergoing ovarian, cervical, endometrial, or gestational-trophoblastic risk and staging assessment

How to apply this result

For a representative case, verify Menopausal Status, Serum CA125, Ultrasound Features, calculate the result, and confirm that its classification matches the highlighted reference band before continuing the disease-specific pathway.

Gynecologic Oncology hubContinue to related calculators and clinical workflow resources.

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Frequently Asked Questions

When should RMI (Risk of Malignancy Index) be used?

Use it for patients undergoing ovarian, cervical, endometrial, or gestational-trophoblastic risk and staging assessment when all required inputs and the intended clinical setting are confirmed.

Can RMI (Risk of Malignancy Index) determine treatment by itself?

No. Interpret the result with the cited evidence, complete clinical assessment, current guidelines, and patient-specific goals.

Evidence-based oncology decision support. Verify with clinical guidelines.