Skip to content

RMI (Risk of Malignancy Index)

RMI 1 (Jacobs 1990); threshold 200

Calculates the Risk of Malignancy Index for an adnexal mass from ultrasound feature count (U), menopausal status (M), and serum CA-125, flagging scores above 200 as high risk warranting gynae-oncology referral.

Also searched as: ovary · adnexal mass · CA-125 · ovarian cancer · gynecology · ovarian · adnexal · pelvic mass

Ultrasound features of malignancy (check all that apply)

Classic Jacobs features: multilocular cyst, solid areas, bilateral lesions, ascites, metastases.

Menopausal status
Serum CA-125
U/mL
Information
Incomplete input
  • Please provide: menopausal status.

How this tool works

The Risk of Malignancy Index combines three preoperative factors into a single product: an ultrasound score based on morphologic features of malignancy, a menopausal score, and the absolute serum CA-125 concentration in U/mL. Originally described by Jacobs and colleagues, RMI remains widely used in triage pathways because it is simple, uses routinely available data, and stratifies who should be referred to a specialist multidisciplinary team. A threshold of 200 is the most commonly applied cut-off for high risk. RMI does not replace expert ultrasound pattern recognition (IOTA Simple Rules, ADNEX, O-RADS) and performs less well in premenopausal women and borderline tumors.

References

Implemented from the cited published sources. Educational use only; confirm against current guidelines before clinical use.

Related calculators

Same subspecialty, overlapping subject matter.