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Background: Ovarian cancers are three times more lethal than breast cancer, despite its lower prevalence rate. Thus, it is imperative to determine if an ovarian mass is benign or malignant to structure a pertinent management protocol. Aim and Objective: The study proposed to preoperatively compare the predictive values of the four risk of malignancy indices (RMIs) and categorized benign and malignant ovarian masses. Methodology: The study included 60 women undergoing surgery for ovarian masses. Parameters such as age, menopausal status, ultrasound findings, tumor size, and cancer antigen (CA)-125 levels were recorded. They were assessed through 4 RMI scores and compared with postsurgical histopathological examination (HPE) report. The sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPVs) were calculated. The level of significance was set atP ≤ 0.05. Results: As per the HPE report, 54 (90%) patients were diagnosed with benign and 6 (10%) with malignant ovarian masses. The median levels of CA-125 were significant (P = 0.014). For the universally recommended RMI cutoff values, sensitivity was 66.7%, specificity ranged from 83.3% to 88.9%, PPV from 36.3% to 40.0%, and NPV from 95.7% to 96%. With the suggested cutoff values obtained by plotting the receiver operating characteristic from the study, sensitivity was 66.6%, specificity ranged from 87.03% to 100.0%, PPV was 100.0%, and NPV was 93.1%. The area under the curve ranged from 0.836 to 0.854. Conclusion: The results of the present study endorse the potency of the RMIs. This certifies that the RMIs are valuable diagnostic tools in discriminating ovarian masses, which could ensure appurtenant management.
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