The value of a radiomics model in predicting ovarian malignancy: a retrospective multi-center comparison with O-RADS and radiologists

Abstract Objectives To develop an MRI–based radiomics model for ovarian masses categorization and to compare the model performance to Ovarian-Adnexal Reporting and Data System (O-RADS) and radiologists’ assessments. Materials and methods This retrospective multicenter study included 497 patients (24...

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Main Authors: Junjie Jin, Xijia Deng, Ling Long, Meiling Liu, Meimei Cao, Hao Gong, Huan Liu, Xiaosong Lan, Lili Liu, Jiuquan Zhang
Format: Article
Language:English
Published: SpringerOpen 2025-07-01
Series:Insights into Imaging
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Online Access:https://doi.org/10.1186/s13244-025-02047-w
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author Junjie Jin
Xijia Deng
Ling Long
Meiling Liu
Meimei Cao
Hao Gong
Huan Liu
Xiaosong Lan
Lili Liu
Jiuquan Zhang
author_facet Junjie Jin
Xijia Deng
Ling Long
Meiling Liu
Meimei Cao
Hao Gong
Huan Liu
Xiaosong Lan
Lili Liu
Jiuquan Zhang
author_sort Junjie Jin
collection DOAJ
description Abstract Objectives To develop an MRI–based radiomics model for ovarian masses categorization and to compare the model performance to Ovarian-Adnexal Reporting and Data System (O-RADS) and radiologists’ assessments. Materials and methods This retrospective multicenter study included 497 patients (249 benign, 248 malignant) allocated to training, internal, and external validation sets (293/124/80 masses, respectively). Radiomics features were extracted from preoperative MRI. Features were selected using minimum redundancy, maximum relevance, and the least absolute shrinkage and selection operator algorithm. Diagnostic performance of the radiomics model, O-RADS, and independent assessments by junior and senior radiologists was evaluated via the area under the receiver operating characteristic curve (AUC) and compared using DeLong’s test. Results In external validation, the radiomics model (AUC = 0.939) outperformed O-RADS (AUC = 0.862; p = 0.047) and the junior radiologist (AUC = 0.802; p = 0.003) and was similar to the senior radiologist (AUC = 0.886; p = 0.231). Subgroup analysis of O-RADS score 4 showed the model (AUC = 0.879) outperformed both radiologists (junior: p = 0.001; senior: p = 0.005). For solid, cystic–solids, and cystic masses, the AUCs of the model were 0.921, 0.975, and 0.848, respectively. Conclusions The performance of the radiomics model to categorize ovarian masses was superior to O-RADS and junior radiologists and similar to senior radiologists. As a complementary tool to O-RADS, it allows for refined risk stratification for ovarian masses with an O-RADS score of 4 and different morphological characteristics, providing clinicians with quantitative decision support to improve preoperative diagnosis and guide treatment planning. Critical relevance statement Radiomics model provides improved risk stratification and supports precise clinical decision-making for ovarian masses with an O-RADS score of 4 and solid, cystic-solid ovarian masses, thereby improving the management of patients with ovarian masses. Key Points MRI–based radiomics allows for the characterization of ovarian masses with high accuracy. Radiomics helps differentiate between benign and malignant ovarian masses with an O-RADS score of 4. For solid, cystic–solid, and cystic masses, the radiomics model exhibited higher or similar performance to that of the O-RADS and radiologists. Graphical Abstract
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spelling doaj-art-258503bad95f4a249dfeb3f2f1bd6c122025-08-20T03:42:49ZengSpringerOpenInsights into Imaging1869-41012025-07-0116111310.1186/s13244-025-02047-wThe value of a radiomics model in predicting ovarian malignancy: a retrospective multi-center comparison with O-RADS and radiologistsJunjie Jin0Xijia Deng1Ling Long2Meiling Liu3Meimei Cao4Hao Gong5Huan Liu6Xiaosong Lan7Lili Liu8Jiuquan Zhang9Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing UniversityDepartment of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing UniversityDepartment of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing UniversityDepartment of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing UniversityDepartment of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing UniversitySchool of Medicine, Chongqing UniversityGE Healthcare, Medical AffairsDepartment of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing UniversityDepartment of Radiology, Chongqing General Hospital, Chongqing UniversityDepartment of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing UniversityAbstract Objectives To develop an MRI–based radiomics model for ovarian masses categorization and to compare the model performance to Ovarian-Adnexal Reporting and Data System (O-RADS) and radiologists’ assessments. Materials and methods This retrospective multicenter study included 497 patients (249 benign, 248 malignant) allocated to training, internal, and external validation sets (293/124/80 masses, respectively). Radiomics features were extracted from preoperative MRI. Features were selected using minimum redundancy, maximum relevance, and the least absolute shrinkage and selection operator algorithm. Diagnostic performance of the radiomics model, O-RADS, and independent assessments by junior and senior radiologists was evaluated via the area under the receiver operating characteristic curve (AUC) and compared using DeLong’s test. Results In external validation, the radiomics model (AUC = 0.939) outperformed O-RADS (AUC = 0.862; p = 0.047) and the junior radiologist (AUC = 0.802; p = 0.003) and was similar to the senior radiologist (AUC = 0.886; p = 0.231). Subgroup analysis of O-RADS score 4 showed the model (AUC = 0.879) outperformed both radiologists (junior: p = 0.001; senior: p = 0.005). For solid, cystic–solids, and cystic masses, the AUCs of the model were 0.921, 0.975, and 0.848, respectively. Conclusions The performance of the radiomics model to categorize ovarian masses was superior to O-RADS and junior radiologists and similar to senior radiologists. As a complementary tool to O-RADS, it allows for refined risk stratification for ovarian masses with an O-RADS score of 4 and different morphological characteristics, providing clinicians with quantitative decision support to improve preoperative diagnosis and guide treatment planning. Critical relevance statement Radiomics model provides improved risk stratification and supports precise clinical decision-making for ovarian masses with an O-RADS score of 4 and solid, cystic-solid ovarian masses, thereby improving the management of patients with ovarian masses. Key Points MRI–based radiomics allows for the characterization of ovarian masses with high accuracy. Radiomics helps differentiate between benign and malignant ovarian masses with an O-RADS score of 4. For solid, cystic–solid, and cystic masses, the radiomics model exhibited higher or similar performance to that of the O-RADS and radiologists. Graphical Abstracthttps://doi.org/10.1186/s13244-025-02047-wOvarian massesMRIRadiomicsOvarian-Adnexal Reporting and Data System
spellingShingle Junjie Jin
Xijia Deng
Ling Long
Meiling Liu
Meimei Cao
Hao Gong
Huan Liu
Xiaosong Lan
Lili Liu
Jiuquan Zhang
The value of a radiomics model in predicting ovarian malignancy: a retrospective multi-center comparison with O-RADS and radiologists
Insights into Imaging
Ovarian masses
MRI
Radiomics
Ovarian-Adnexal Reporting and Data System
title The value of a radiomics model in predicting ovarian malignancy: a retrospective multi-center comparison with O-RADS and radiologists
title_full The value of a radiomics model in predicting ovarian malignancy: a retrospective multi-center comparison with O-RADS and radiologists
title_fullStr The value of a radiomics model in predicting ovarian malignancy: a retrospective multi-center comparison with O-RADS and radiologists
title_full_unstemmed The value of a radiomics model in predicting ovarian malignancy: a retrospective multi-center comparison with O-RADS and radiologists
title_short The value of a radiomics model in predicting ovarian malignancy: a retrospective multi-center comparison with O-RADS and radiologists
title_sort value of a radiomics model in predicting ovarian malignancy a retrospective multi center comparison with o rads and radiologists
topic Ovarian masses
MRI
Radiomics
Ovarian-Adnexal Reporting and Data System
url https://doi.org/10.1186/s13244-025-02047-w
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