Risk assessment for locating an ovarian malignancy during surgery in women who present with an adnexal mass. The test is not intended as a screening or stand-alone diagnostic assay for ovarian cancer. Women with ovarian cancer symptoms and adnexal masses present primarily to gynecologists, medical care physicians or general surgeons. Triage guidelines from the American College of Obstetricians and Gynecologists and the Society of Gynecologic Oncologists recommend referral of women with a pelvic mass at high risk for ovarian cancer to gynecologic, oncologists. Specialized treatment improves patient outcomes leading to fewer complications and better survival rates in comparison to patients treated by surgeons less conversant in the management of ovarian cancer. ROMA is indicated for women who meet the following criteria: older than age 18, presenting with an adnexal mass for which surgery is planned, and who have not yet been referred to an oncologist. ROMA must be interpreted in conjunction with the clinical and radiological assessment.