The Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
Department of Ultrasound, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, China.
Br J Radiol. 2024 Oct 1;97(1162):1706-1712. doi: 10.1093/bjr/tqae144.
CA125 is recommended by many countries as the primary screening test for ovarian cancer. But there are patients with ovarian cancer having normal CA125. We hope to identify the types of EOC with normal CA125 levels better by building a refined model based on the ultrasound radiomics, thus providing precise medical treatment for patients.
We included 58 patients with EOC with normal CA125 from 2 centres, who were confirmed by preoperative ultrasound and pathology. We extracted 1130 radiomics features based on the tumour's region of interest from the most typical ultrasound image of each patient. We selected radiomics and clinical features by LASSO and logistic regression to construct Rad-score and clinical models, respectively. Receiver operating characteristic curves judged their test efficacy. On the basis of the combined model, we developed a nomogram.
Area under the curves (AUCs) of 0.93 and 0.83 were achieved in both the training and test groups for the combined model. There were similar AUCs between the Rad-score and clinical models of 0.82 and 0.80, respectively. By analysing the calibration curves, it was determined that the nomogram matched actual observations in the training cohort.
Ultrasound radiomics can differentiate type I and type II EOC with normal CA125 levels.
This study is the first to focus on EOC cases with normal level of CA125. The subset of patients constituting 20% of the disease population may require more refined radiomics models.
许多国家推荐 CA125 作为卵巢癌的主要筛查试验。但有些卵巢癌患者的 CA125 正常。我们希望通过构建基于超声放射组学的精细模型，更好地识别 CA125 水平正常的卵巢上皮癌（EOC）类型，从而为患者提供精准的医疗服务。
我们纳入了来自 2 个中心的 58 例 CA125 正常的 EOC 患者，这些患者通过术前超声和病理得到证实。我们从每位患者最典型的超声图像中提取了 1130 个基于肿瘤感兴趣区的放射组学特征。我们通过 LASSO 和逻辑回归选择放射组学和临床特征，分别构建 Rad-score 和临床模型。受试者工作特征曲线判断它们的测试效果。在此基础上，我们开发了一个列线图。
训练组和测试组的联合模型的曲线下面积（AUC）分别为 0.93 和 0.83。Rad-score 模型和临床模型的 AUC 分别为 0.82 和 0.80，两者相似。通过分析校准曲线，发现列线图在训练队列中与实际观察结果相符。
超声放射组学可区分 CA125 水平正常的 I 型和 II 型 EOC。
本研究首次聚焦于 CA125 水平正常的 EOC 病例。占疾病人群 20%的这部分患者可能需要更精细的放射组学模型。
