COMPARISON OF SCORING SYSTEMS IN ASSESSING THE RISK OF MALIGNANCY IN OVARIAN CYSTS: A LITERATURE REVIEW AND CLINICAL IMPLICATIONS

I Gde Sastra Winata (Department of Obstetrics and Gynecology, Faculty of Medicine, Udayana University, Bali, Indonesia)
Jessica Nathalia (Department of Obstetrics and Gynecology, Faculty of Medicine, Udayana University, Bali, Indonesia)

Jurnal Kedokteran Diponegoro
Vol 15, No 5 (2026): JURNAL KEDOKTERAN DIPONEGORO (DIPONEGORO MEDICAL JOURNAL)

Background: Preoperative assessment of ovarian cysts with suspected malignancy requires reliable scoring systems to distinguish between benign and malignant lesions. Several scoring systems have been developed, including the Risk of Malignancy Index (RMI), IOTA Simple Rules, and IOTA ADNEX. Objective: To review the literature on the diagnostic accuracy of these scoring systems, compare their strengths and weaknesses, and discuss their clinical implications. Methods: Literature search from open-access databases until the most recent articles, including studies comparing scoring systems for ovarian/adnexal masses. Results: Several studies show that IOTA models (especially ADNEX) have higher diagnostic performance (AUC) compared to RMI. However, each system has limitations in clinical applications. Conclusion: The choice of scoring system should consider local facilities (ultrasound, tumor markers, imaging expertise) and patient risk; the use of high-performing models can improve triage and management of patients with ovarian cysts.