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In European radiology experimental

BACKGROUND : To evaluate the performance of a decision support system (DSS) based on radiomics and machine learning in predicting the risk of malignancy of ovarian masses (OMs) from transvaginal ultrasonography (TUS) and serum CA-125.

METHODS : A total of 274 consecutive patients who underwent TUS (by different examiners and with different ultrasound machines) and surgery, with suspicious OMs and known CA-125 serum level were used to train and test a DSS. The DSS was used to predict the risk of malignancy of these masses (very low versus medium-high risk), based on the US appearance (solid, liquid, or mixed) and radiomic features (morphometry and regional texture features) within the masses, on the shadow presence (yes/no), and on the level of serum CA-125. Reproducibility of results among the examiners, and performance accuracy, sensitivity, specificity, and area under the curve were tested in a real-world clinical setting.

RESULTS : The DSS showed a mean 88% accuracy, 99% sensitivity, and 77% specificity for the 239 patients used for training, cross-validation, and testing, and a mean 91% accuracy, 100% sensitivity, and 80% specificity for the 35 patients used for independent testing.

CONCLUSIONS : This DSS is a promising tool in women diagnosed with OMs at TUS, allowing to predict the individual risk of malignancy, supporting clinical decision making.

Chiappa Valentina, Interlenghi Matteo, Bogani Giorgio, Salvatore Christian, Bertolina Francesca, Sarpietro Giuseppe, Signorelli Mauro, Ronzulli Dominique, Castiglioni Isabella, Raspagliesi Francesco


Artificial intelligence, CA-125 antigen, Machine learning, Ovarian neoplasms, Ultrasonography