NICE clinical guidelines
Issued: April 2011
CG122

Ovarian cancer: The recognition and initial management of ovarian cancer

This is an extract from the guidance. The complete guidance is available at guidance.nice.org.uk/cg122

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.