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Objective The purpose of this study was to evaluate the ability of the four malignancy risk indices for discrimination of a benign mass from a malignant pelvic mass. Methods This is a retrospective study of 547 women admitted to the Department of Obstetrics and Gynecology of Inha University College of Medicine, between January, 2007, and December, 2010, for surgical exploration of a pelvic mass. Sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy of four risk of malignancy indices (RMIs: RMI 1, RMI 2, RMI 3, and RMI 4) were obtained for diagnosis of a malignant pelvic mass. Results Results of receiver operating characteristic analysis of RMI 1-4, CA-125 serum levels, ultrasound score, menopausal status, and tumor size showed values of the area under the curve of 0.9233, 0.9151, 0.9132, 0.9263, 0.8472, 0.9007, 5870, and 0.7714, respectively. The four RMIs showed statistical significance with menopausal status (P=0.001) and tumor size (P=0.03), but not with CA-125 and ultrasound score (P>0.05). Conclusion Four RMIs were found to be statistically significant diagnostic criteria, compared with menopausal status and tumor size, which can discriminate between benign and malignant pelvic masses.

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