🎗️ Risk of Malignancy Index (RMI, Adnexal Mass)
Estimate malignancy risk of an adnexal mass with the Risk of Malignancy Index (RMI).
Risk of Malignancy Index (RMI, Adnexal Mass)
RMI version
Number of ultrasound features (multilocular/solid/bilateral/ascites/intra-abdominal metastases)
Menopausal status
Serum CA-125 (U/mL)
When to use
Triage adnexal masses and decide on gynecologic-oncology referral.
How it works
RMI = ultrasound score U × menopausal status M × CA-125. RMI 1: U = 0/1/3, M = 1/3; RMI 2: U = 1/1/4, M = 1/4. ≥ 200 = elevated risk.
Key points
- ≥ 200 warrants gynecologic-oncology referral.
- Complementary to O-RADS imaging.
- RMI 1 is more specific, RMI 2 more sensitive.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.