Benign Gynecologic Mass Growth Rate Calculator

An evidence-based web application for estimating growth patterns of benign gynecologic masses with enhanced accuracy using validated clinical models and latest research data.

Version 8.0 Features

New in Version 8.0

• Deterministic Calculation Mode: Choose between deterministic (reproducible median values) and probabilistic (statistical distribution) calculation modes
• ROMA Score Calculator: Risk of Ovarian Malignancy Algorithm using CA-125 and HE4 tumor markers
• RMI Calculator: Risk of Malignancy Index integration for comprehensive malignancy risk assessment
• FIGO/PALM-COEIN Classification: Standardized fibroid classification system
• IOTA Simple Rules: Validated ultrasound-based malignancy risk assessment
• Enhanced Confidence Intervals: Prominently displayed 95% confidence intervals for all projections
• Tumor Marker Integration: CA-125 and HE4 input fields for malignancy risk calculation
• Export/Print Functionality: Export results as HTML report or print directly
• Comprehensive Citation References: PubMed IDs and citations for all evidence-based values

Core Features

• Five Mass Types: Endometrioma, Uterine Fibroids, Simple Ovarian Cysts, Complex Ovarian Cysts, and Adenomyosis
• Li et al. Predictive Model: 82.5% accuracy with laboratory value integration (FSH, LH, lipid profile)
• Multi-Time Point Projections: 3, 6, 12, 24, and 36-month growth forecasts
• Volume-Based Calculations: More accurate than diameter-based measurements
• Enhanced Risk Stratification: IOTA Simple Rules and O-RADS categories for complex cysts
• Evidence-Based Algorithms: Based on comprehensive peer-reviewed research data

Scientific Evidence Base

Endometrioma Growth Rates

Source	PMID	Key Finding
Muzii L, et al. 2020	32215556	Median -1.7mm/year; 47% decrease, 31% stable, 22% increase
Guo SW. 2009	33558225	OR 3.245 for previous history; 51% at 36 months untreated
Vercellini P, et al. 2018	28881472	94% recurrence-free at 36 months with continuous OCP
Li et al. 2019	30825145	Predictive model AUC 0.825, R² 0.79

Uterine Fibroid Growth Rates

Source	PMID	Key Finding
Peddada SD, et al. 2008	23674421	9-89% growth over 18 months; 188% for <1cm fibroids
Bhave Chittawar P, et al. 2014	26196297	41.6% recurrence at 3 years (laparoscopic), 31-43% (open)
Marshall LM, et al. 1997	12516827	2-3x higher incidence in African American women

Ovarian Cyst Natural History

Source	PMID	Key Finding
Greenlee RT, et al. 2010	20630057	70-80% resolve in 2-3 cycles (premenopausal)
Modesitt SC, et al. 2003	19037038	32% resolve at 1 year; 15-20% malignant potential (postmenopausal)
Caspi B, et al. 1997	10669551	Dermoid: 1.8 mm/year; >2cm/year excludes dermoid
Patel MD, et al. 2005	16322114	Hemorrhagic: 87.5% resolve within 6 weeks

Malignancy Risk Assessment

Calculator	PMID	Performance
ROMA	19962172	Sensitivity 92.3%, Specificity 76.0%
RMI	2398886	Sensitivity 70-87%, Specificity 89-97%
IOTA Simple Rules	18977552	Sensitivity 95%, Specificity 91%
O-RADS	32134991	Standardized risk categorization

Adenomyosis Progression

Source	PMID	Key Finding
Exacoustos C, et al. 2017	28922625	21.3% progression at 12 months; 48% annual volume growth
Reinhold C, et al. 1999	25681495	Diagnostic threshold ≥12mm; 15.1% annual JZ thickening

Calculation Modes

Deterministic Mode (Default)

• Uses median values from research for reproducible results
• Ideal for clinical documentation and comparison
• Same inputs will always produce the same outputs

Probabilistic Mode

• Uses statistical distributions from research
• Models natural biological variability
• Results may vary between calculations

Risk Assessment Tools

ROMA Score (Risk of Ovarian Malignancy Algorithm)

Formula based on menopausal status:

• Premenopausal: PI = -12.0 + 2.38×ln(HE4) + 0.0626×ln(CA125)
• Postmenopausal: PI = -8.09 + 1.04×ln(HE4) + 0.732×ln(CA125)
• ROMA = exp(PI) / (1 + exp(PI)) × 100%
• Cutoffs: 7.4% (premenopausal), 25.3% (postmenopausal)

RMI (Risk of Malignancy Index)

• Formula: RMI = U × M × CA-125
• U (Ultrasound score): 0 = no features, 1 = one feature, 3 = 2+ features
• M (Menopausal status): 1 = premenopausal, 3 = postmenopausal
• Cutoff: RMI ≥200 indicates high risk

IOTA Simple Rules

Five B-features (Benign) and five M-features (Malignant):

• If only B-features present: Classify as benign
• If only M-features present: Classify as malignant
• If both or neither: Inconclusive - apply subjective assessment

FIGO Classification (Fibroids)

• Type 0-2: Submucosal (high symptom risk)
• Type 3-4: Intramural (moderate symptom risk)
• Type 5-7: Subserosal (low symptom risk)
• Type 8: Other locations

File Structure

ROG-Estimator/
├── index.html          # Main HTML structure with enhanced UI
├── styles.css          # CSS styling with new components
├── script.js           # JavaScript algorithms and calculators
└── README.md           # Documentation with evidence citations

Usage

1. Open index.html in a web browser
2. Select the type of gynecologic mass
3. Choose calculation mode (deterministic or probabilistic)
4. Fill in required information (current size, age, projection period)
5. Complete optional fields for enhanced accuracy:
   • Tumor markers (CA-125, HE4) for malignancy risk
   • Ultrasound features for IOTA assessment
   • FIGO classification for fibroids
6. Click "Calculate Growth Projection" to view results
7. Export or print results as needed

Supported Mass Types

Endometrioma

• Growth distribution: 47% decrease, 31% stable, 22% increase
• Treatment effects: Continuous OCP reduces recurrence by 90%
• Li et al. model integration with laboratory values
• Recurrence risk stratification

Uterine Fibroids

• Size-dependent growth (188% for <1cm, 9-89% for 2-5cm)
• FIGO/PALM-COEIN classification system
• Post-myomectomy recurrence prediction
• Race and age-adjusted algorithms

Simple Ovarian Cysts

• Resolution rates: 70-80% in 2-3 cycles
• Postmenopausal risk assessment
• ROMA and RMI score integration
• PCOS-specific considerations

Complex Ovarian Cysts

• Type-specific growth patterns
• IOTA Simple Rules assessment
• O-RADS risk stratification
• Full tumor marker integration

Adenomyosis

• Evidence-based progression rates
• JZ thickness monitoring
• Type-specific algorithms (diffuse vs focal)
• Treatment response prediction

Medical Disclaimer

This calculator uses published research data for educational purposes only. Individual patient factors may significantly affect actual growth rates. The risk calculators (ROMA, RMI, IOTA) are decision support tools and do not replace clinical judgment or histopathological diagnosis. Always consult with a healthcare provider for personalized medical guidance and treatment decisions.

Technical Details

• Frontend: Pure HTML, CSS, and JavaScript
• No Dependencies: Self-contained application
• Responsive Design: Works on desktop and mobile devices
• Print Optimized: CSS print styles for clean output
• Evidence-Based: All algorithms cite peer-reviewed research

Changelog

Version 8.0 (Current)

• Added deterministic/probabilistic calculation modes
• Implemented ROMA Score Calculator
• Implemented RMI Calculator
• Added FIGO/PALM-COEIN classification
• Added IOTA Simple Rules assessment
• Enhanced confidence interval display
• Added tumor marker input fields
• Added export/print functionality
• Comprehensive PubMed citation system

Version 7.0

• Added adenomyosis calculator
• Enhanced fibroid multiplicity assessment
• Improved treatment effectiveness data

Previous Versions

• Initial implementation with basic growth calculations
• Added Li et al. predictive model
• Multi-time projections
• O-RADS integration