Ovarian cancer: The recognition and initial management of ovarian cancer

NICE guidelines [CG122] Published date:

Appendix D: Risk of malignancy index (RMI I)

Appendix D: Risk of malignancy index (RMI I)

RMI I combines three pre-surgical features: serum CA125 (CA125), menopausal status (M) and ultrasound score (U). The RMI is a product of the ultrasound scan score, the menopausal status and the serum CA125 level (IU/ml).

RMI = U x M x CA125

  • The ultrasound result is scored 1 point for each of the following characteristics: multilocular cysts, solid areas, metastases, ascites and bilateral lesions. U = 0 (for an ultrasound score of 0), U = 1 (for an ultrasound score of 1), U = 3 (for an ultrasound score of 2–5).

  • The menopausal status is scored as 1 = pre-menopausal and 3 = post-menopausal

  • The classification of 'post-menopausal' is a woman who has had no period for more than 1 year or a woman over 50 who has had a hysterectomy.

  • Serum CA125 is measured in IU/ml and can vary between 0 and hundreds or even thousands of units.

NICE has accredited the process used by the Centre for Clinical Practice at NICE to produce guidelines. Accreditation is valid for 5 years from September 2009 and applies to guidelines produced since April 2007 using the processes described in NICE's 'The guidelines manual' (2007, updated 2009). More information on accreditation can be viewed at www.nice.org.uk/accreditation
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