{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T13:02:03Z","timestamp":1775048523432,"version":"3.50.1"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":36,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/501100004829","name":"Science and Technology Department of Sichuan Province","doi-asserted-by":"publisher","award":["2024YFHZ0062"],"award-info":[{"award-number":["2024YFHZ0062"]}],"id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004829","name":"Science and Technology Department of Sichuan Province","doi-asserted-by":"publisher","award":["2024YFHZ0062"],"award-info":[{"award-number":["2024YFHZ0062"]}],"id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004829","name":"Science and Technology Department of Sichuan Province","doi-asserted-by":"publisher","award":["2024YFHZ0062"],"award-info":[{"award-number":["2024YFHZ0062"]}],"id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004829","name":"Science and Technology Department of Sichuan Province","doi-asserted-by":"publisher","award":["2024YFHZ0062"],"award-info":[{"award-number":["2024YFHZ0062"]}],"id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004829","name":"Science and Technology Department of Sichuan Province","doi-asserted-by":"publisher","award":["2024YFHZ0062"],"award-info":[{"award-number":["2024YFHZ0062"]}],"id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004829","name":"Science and Technology Department of Sichuan Province","doi-asserted-by":"publisher","award":["2024YFHZ0062"],"award-info":[{"award-number":["2024YFHZ0062"]}],"id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004829","name":"Science and Technology Department of Sichuan Province","doi-asserted-by":"publisher","award":["2024YFHZ0062"],"award-info":[{"award-number":["2024YFHZ0062"]}],"id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004829","name":"Science and Technology Department of Sichuan Province","doi-asserted-by":"publisher","award":["2024YFHZ0062"],"award-info":[{"award-number":["2024YFHZ0062"]}],"id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004829","name":"Science and Technology Department of Sichuan Province","doi-asserted-by":"publisher","award":["2024YFHZ0062"],"award-info":[{"award-number":["2024YFHZ0062"]}],"id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004829","name":"Science and Technology Department of Sichuan Province","doi-asserted-by":"publisher","award":["2024YFHZ0062"],"award-info":[{"award-number":["2024YFHZ0062"]}],"id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004829","name":"Science and Technology Department of Sichuan Province","doi-asserted-by":"publisher","award":["2024YFHZ0062"],"award-info":[{"award-number":["2024YFHZ0062"]}],"id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004829","name":"Science and Technology Department of Sichuan Province","doi-asserted-by":"publisher","award":["2024YFHZ0062"],"award-info":[{"award-number":["2024YFHZ0062"]}],"id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004829","name":"Science and Technology Department of Sichuan Province","doi-asserted-by":"publisher","award":["2024YFHZ0062"],"award-info":[{"award-number":["2024YFHZ0062"]}],"id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004829","name":"Science and Technology Department of Sichuan Province","doi-asserted-by":"publisher","award":["2024YFHZ0062"],"award-info":[{"award-number":["2024YFHZ0062"]}],"id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004829","name":"Science and Technology Department of Sichuan Province","doi-asserted-by":"publisher","award":["2024YFHZ0062"],"award-info":[{"award-number":["2024YFHZ0062"]}],"id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004829","name":"Science and Technology Department of Sichuan Province","doi-asserted-by":"publisher","award":["2024YFHZ0062"],"award-info":[{"award-number":["2024YFHZ0062"]}],"id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["npj Digit. Med."],"DOI":"10.1038\/s41746-026-02459-y","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T09:37:38Z","timestamp":1771925858000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Distinction between primary and metastatic mucinous ovarian carcinoma from histopathology images using deep learning"],"prefix":"10.1038","volume":"9","author":[{"given":"Ming-Yi","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhao-Juan","family":"Qin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yue-Di","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhi-Qian","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui-Zhi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhi-Xiang","family":"Xia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiong-Xian","family":"Long","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jia","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao-Li","family":"Mou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lian-Sha","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong-Shuai","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen-Jun","family":"Meng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ai","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang-Mei","family":"Shen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji-Yan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,2,24]]},"reference":[{"key":"2459_CR1","doi-asserted-by":"publisher","first-page":"1256","DOI":"10.1056\/NEJMra1813254","volume":"380","author":"P Morice","year":"2019","unstructured":"Morice, P., Gouy, S. & Leary, A. Mucinous Ovarian Carcinoma. N. Engl. J. Med. 380, 1256\u20131266 (2019).","journal-title":"N. Engl. J. Med."},{"key":"2459_CR2","doi-asserted-by":"publisher","first-page":"i53","DOI":"10.1093\/annonc\/mdw087","volume":"27","author":"TJ Perren","year":"2016","unstructured":"Perren, T. J. Mucinous epithelial ovarian carcinoma. Ann. Oncol. 27, i53\u2013i57 (2016).","journal-title":"Ann. Oncol."},{"key":"2459_CR3","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1136\/jclinpath-2011-200162","volume":"65","author":"SL Leen","year":"2012","unstructured":"Leen, S. L. & Singh, N. Pathology of primary and metastatic mucinous ovarian neoplasms. J. Clin. Pathol. 65, 591\u2013595 (2012).","journal-title":"J. Clin. Pathol."},{"key":"2459_CR4","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1186\/s13000-021-01079-2","volume":"16","author":"P Dundr","year":"2021","unstructured":"Dundr, P. et al. Primary mucinous ovarian tumors vs. ovarian metastases from gastrointestinal tract, pancreas and biliary tree: a review of current problematics. Diagn. Pathol. 16, 20 (2021).","journal-title":"Diagn. Pathol."},{"key":"2459_CR5","doi-asserted-by":"publisher","DOI":"10.1186\/s12893-022-01565-4","volume":"22","author":"Y Maeda","year":"2022","unstructured":"Maeda, Y., Minagawa, N., Shoji, H., Kobayashi, T. & Yamamoto, K. Giant ovarian tumor with colorectal cancer: suggestion concerning the need for colonoscopy screening in cases with large ovarian tumor-a report of three cases. BMC Surg. 22, 111 (2022).","journal-title":"BMC Surg."},{"key":"2459_CR6","doi-asserted-by":"publisher","first-page":"257","DOI":"10.3892\/ol.2016.4553","volume":"12","author":"J Shimazaki","year":"2016","unstructured":"Shimazaki, J. et al. Synchronous ovarian metastasis from colorectal cancer: A report of two cases. Oncol. Lett. 12, 257\u2013261 (2016).","journal-title":"Oncol. Lett."},{"key":"2459_CR7","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1136\/jcp.2010.085688","volume":"65","author":"WG McCluggage","year":"2012","unstructured":"McCluggage, W. G. Immunohistochemistry in the distinction between primary and metastatic ovarian mucinous neoplasms. J. Clin. Pathol. 65, 596\u2013600 (2012).","journal-title":"J. Clin. Pathol."},{"key":"2459_CR8","doi-asserted-by":"publisher","first-page":"5383","DOI":"10.1158\/1078-0432.CCR-22-1206","volume":"28","author":"NS Meagher","year":"2022","unstructured":"Meagher, N. S. et al. Gene-Expression Profiling of Mucinous Ovarian Tumors and Comparison with Upper and Lower Gastrointestinal Tumors Identifies Markers Associated with Adverse Outcomes. Clin. Cancer Res. 28, 5383\u20135395 (2022).","journal-title":"Clin. Cancer Res."},{"key":"2459_CR9","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1136\/jclinpath-2015-202951","volume":"68","author":"A Hu","year":"2015","unstructured":"Hu, A. et al. Differentiating primary and extragenital metastatic mucinous ovarian tumours: an algorithm combining PAX8 with tumour size and laterality. J. Clin. Pathol. 68, 522\u2013528 (2015).","journal-title":"J. Clin. Pathol."},{"key":"2459_CR10","doi-asserted-by":"publisher","first-page":"e18","DOI":"10.1016\/S2589-7500(21)00211-9","volume":"4","author":"J Kers","year":"2022","unstructured":"Kers, J. et al. Deep learning-based classification of kidney transplant pathology: a retrospective, multicentre, proof-of-concept study. Lancet Digit Health 4, e18\u2013e26 (2022).","journal-title":"Lancet Digit Health"},{"key":"2459_CR11","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1038\/s41586-021-03512-4","volume":"594","author":"MY Lu","year":"2021","unstructured":"Lu, M. Y. et al. AI-based pathology predicts origins for cancers of unknown primary. Nature 594, 106\u2013110 (2021).","journal-title":"Nature"},{"key":"2459_CR12","doi-asserted-by":"publisher","first-page":"1559","DOI":"10.1038\/s41591-018-0177-5","volume":"24","author":"N Coudray","year":"2018","unstructured":"Coudray, N. et al. Classification and mutation prediction from non-small cell lung cancer histopathology images using deep learning. Nat. Med. 24, 1559\u20131567 (2018).","journal-title":"Nat. Med."},{"key":"2459_CR13","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1038\/s41746-024-01131-7","volume":"7","author":"CW Wang","year":"2024","unstructured":"Wang, C. W. et al. Deep learning to assess microsatellite instability directly from histopathological whole slide images in endometrial cancer. NPJ Digit Med. 7, 143 (2024).","journal-title":"NPJ Digit Med."},{"key":"2459_CR14","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-024-48667-6","volume":"15","author":"B Ahn","year":"2024","unstructured":"Ahn, B. et al. Histopathologic image-based deep learning classifier for predicting platinum-based treatment responses in high-grade serous ovarian cancer. Nat. Commun. 15, 4253 (2024).","journal-title":"Nat. Commun."},{"key":"2459_CR15","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1038\/s41746-024-01003-0","volume":"7","author":"Y Zhang","year":"2024","unstructured":"Zhang, Y. et al. Histopathology images-based deep learning prediction of prognosis and therapeutic response in small cell lung cancer. NPJ Digit Med. 7, 15 (2024).","journal-title":"NPJ Digit Med."},{"key":"2459_CR16","doi-asserted-by":"publisher","first-page":"3000","DOI":"10.1109\/TMI.2023.3273236","volume":"42","author":"J Shi","year":"2023","unstructured":"Shi, J. et al. A Structure-Aware Hierarchical Graph-Based Multiple Instance Learning Framework for pT Staging in Histopathological Image. IEEE Trans. Med Imaging 42, 3000\u20133011 (2023).","journal-title":"IEEE Trans. Med Imaging"},{"key":"2459_CR17","doi-asserted-by":"publisher","first-page":"1983","DOI":"10.1038\/s41379-022-01146-z","volume":"35","author":"H Farahani","year":"2022","unstructured":"Farahani, H. et al. Deep learning-based histotype diagnosis of ovarian carcinoma whole-slide pathology images. Mod. Pathol. 35, 1983\u20131990 (2022).","journal-title":"Mod. Pathol."},{"key":"2459_CR18","doi-asserted-by":"publisher","first-page":"985","DOI":"10.1097\/00000478-200307000-00014","volume":"27","author":"JD Seidman","year":"2003","unstructured":"Seidman, J. D., Kurman, R. J. & Ronnett, B. M. Primary and metastatic mucinous adenocarcinomas in the ovaries: incidence in routine practice with a new approach to improve intraoperative diagnosis. Am. J. Surg. Pathol. 27, 985\u2013993 (2003).","journal-title":"Am. J. Surg. Pathol."},{"key":"2459_CR19","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1097\/PAS.0b013e3180690d2d","volume":"32","author":"AV Yemelyanova","year":"2008","unstructured":"Yemelyanova, A. V., Vang, R., Judson, K., Wu, L. S. & Ronnett, B. M. Distinction of primary and metastatic mucinous tumors involving the ovary: analysis of size and laterality data by primary site with reevaluation of an algorithm for tumor classification. Am. J. Surg. Pathol. 32, 128\u2013138 (2008).","journal-title":"Am. J. Surg. Pathol."},{"key":"2459_CR20","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1016\/j.ygyno.2005.10.008","volume":"101","author":"S Khunamornpong","year":"2006","unstructured":"Khunamornpong, S. et al. Primary and metastatic mucinous adenocarcinomas of the ovary: Evaluation of the diagnostic approach using tumor size and laterality. Gynecol. Oncol. 101, 152\u2013157 (2006).","journal-title":"Gynecol. Oncol."},{"key":"2459_CR21","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1007\/s00428-018-2504-0","volume":"474","author":"M Simons","year":"2019","unstructured":"Simons, M. et al. A novel algorithm for better distinction of primary mucinous ovarian carcinomas and mucinous carcinomas metastatic to the ovary. Virchows Arch. 474, 289\u2013296 (2019).","journal-title":"Virchows Arch."},{"key":"2459_CR22","doi-asserted-by":"crossref","unstructured":"Asadi-Aghbolaghi M. et al. Machine Learning-Driven Histotype Diagnosis of Ovarian Carcinoma: Insights from the OCEAN AI Challenge. medRxiv (2024).","DOI":"10.1101\/2024.04.19.24306099"},{"key":"2459_CR23","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-021-21674-7","volume":"12","author":"X Wang","year":"2021","unstructured":"Wang, X. et al. Predicting gastric cancer outcome from resected lymph node histopathology images using deep learning. Nat. Commun. 12, 1637 (2021).","journal-title":"Nat. Commun."},{"key":"2459_CR24","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-022-30459-5","volume":"13","author":"X Zheng","year":"2022","unstructured":"Zheng, X. et al. A deep learning model and human-machine fusion for prediction of EBV-associated gastric cancer from histopathology. Nat. Commun. 13, 2790 (2022).","journal-title":"Nat. Commun."},{"key":"2459_CR25","first-page":"9240","volume":"32","author":"R Ying","year":"2019","unstructured":"Ying, R., Bourgeois, D., You, J., Zitnik, M. & Leskovec, J. GNNExplainer: Generating Explanations for Graph Neural Networks. Adv. Neural Inf. Process Syst. 32, 9240\u20139251 (2019).","journal-title":"Adv. Neural Inf. Process Syst."}],"container-title":["npj Digital Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41746-026-02459-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41746-026-02459-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41746-026-02459-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T11:50:20Z","timestamp":1775044220000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41746-026-02459-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,24]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["2459"],"URL":"https:\/\/doi.org\/10.1038\/s41746-026-02459-y","relation":{},"ISSN":["2398-6352"],"issn-type":[{"value":"2398-6352","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,24]]},"assertion":[{"value":"24 December 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"276"}}