{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T17:51:15Z","timestamp":1792432275521,"version":"4.5.0"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T00:00:00Z","timestamp":1709856000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Accurately differentiating between ovarian endometrioma and ovarian dermoid cyst is of clinical significance. However, the ultrasound appearance of these two diseases is variable, occasionally causing confusion and overlap with each other. This study aimed to develop a diagnostic classification model based on ultrasound radiomics to intelligently distinguish and diagnose the two diseases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We collected ovarian ultrasound images from participants diagnosed as patients with ovarian endometrioma or ovarian dermoid cyst. Feature extraction and selection were performed using the Mann-Whitney <jats:italic>U<\/jats:italic>-test, Spearman correlation analysis, and the least absolute shrinkage and selection operator (LASSO) regression. We then input the final features into the machine learning classifiers for model construction. A nomogram was established by combining the radiomic signature and clinical signature.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 407 participants with 407 lesions were included and categorized into the ovarian endometriomas group (<jats:italic>n<\/jats:italic> = 200) and the dermoid cyst group (<jats:italic>n<\/jats:italic> = 207). In the test cohort, Logistic Regression (LR) achieved the highest area under curve (AUC) value (0.981, 95% CI: 0.963\u22121.000), the highest accuracy (94.8%), and the highest sensitivity (95.5%), while LightGBM achieved the highest specificity (97.1%). A nomogram incorporating both clinical features and radiomic features achieved the highest level of performance (AUC: 0.987, 95% CI: 0.967\u22121.000, accuracy: 95.1%, sensitivity: 88.0%, specificity: 100.0%, PPV: 100.0%, NPV: 88.0%, precision: 93.6%). No statistical difference in diagnostic performance was observed between the radiomic model and the nomogram (<jats:italic>P<\/jats:italic> &amp;gt; 0.05). The diagnostic indexes of radiomic model were comparable to that of senior radiologists and superior to that of junior radiologist. The diagnostic performance of junior radiologists significantly improved with the assistance of the model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This ultrasound radiomics-based model demonstrated superior diagnostic performance compared to those of junior radiologists and comparable diagnostic performance to those of senior radiologists, and it has the potential to enhance the diagnostic performance of junior radiologists.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2024.1362588","type":"journal-article","created":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T04:15:00Z","timestamp":1709871300000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":19,"title":["Ultrasound radiomics-based artificial intelligence model to assist in the differential diagnosis of ovarian endometrioma and ovarian dermoid cyst"],"prefix":"10.3389","volume":"11","author":[{"given":"Lu","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjun","family":"Cai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenyang","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyan","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beibei","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guanghui","family":"Yue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Hao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,3,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"632","DOI":"10.1002\/uog.26175","article-title":"Prevalence of deep and ovarian endometriosis in women attending a general gynecology clinic: prospective cohort study.","volume":"61","author":"Chaggar","year":"2023","journal-title":"Ultrasound Obstet Gynecol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1007\/s13244-016-0539-9","article-title":"Mature cystic teratoma of the ovary: a cutting edge overview on imaging features.","volume":"8","author":"Sahin","year":"2017","journal-title":"Insights Imaging."},{"key":"B3","doi-asserted-by":"publisher","first-page":"S34","DOI":"10.2214\/AJR.07.7142","article-title":"Unusual manifestations and complications of endometriosis\u2013spectrum of imaging findings: pictorial review.","volume":"194","author":"Bennett","year":"2010","journal-title":"AJR Am J Roentgenol."},{"key":"B4","doi-asserted-by":"crossref","DOI":"10.3390\/jpm11070611","article-title":"Ultrasonography in the differentiation of endometriomas from hemorrhagic ovarian cysts: the role of texture analysis.","volume":"11","author":"\u015etefan","year":"2021","journal-title":"J Pers Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1148\/radiol.2019191150","article-title":"O-RADS US risk stratification and management system: a consensus guideline from the ACR ovarian-adnexal reporting and data system committee.","volume":"294","author":"Andreotti","year":"2020","journal-title":"Radiology."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1723","DOI":"10.1093\/humrep\/dew113","article-title":"Age-related differences in the sonographic characteristics of endometriomas.","volume":"31","author":"Guerriero","year":"2016","journal-title":"Hum Reprod."},{"key":"B7","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1002\/uog.7668","article-title":"Endometriomas: their ultrasound characteristics.","volume":"35","author":"Van Holsbeke","year":"2010","journal-title":"Ultrasound Obstet Gynecol."},{"key":"B8","doi-asserted-by":"crossref","first-page":"993","DOI":"10.7863\/jum.2007.26.8.993","article-title":"Variations in appearance of endometriomas.","volume":"26","author":"Asch","year":"2007","journal-title":"J Ultrasound Med."},{"key":"B9","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1016\/S1470-2045(08)70306-1","article-title":"Squamous-cell carcinoma in mature cystic teratoma of the ovary: systematic review and analysis of published data.","volume":"9","author":"Hackethal","year":"2008","journal-title":"Lancet Oncol."},{"key":"B10","doi-asserted-by":"crossref","DOI":"10.3390\/ijms24076141","article-title":"Mature cystic teratoma: an integrated review.","volume":"24","author":"Cong","year":"2023","journal-title":"Int J Mol Sci."},{"key":"B11","doi-asserted-by":"crossref","first-page":"2631","DOI":"10.1002\/cncr.11345","article-title":"Pathology and classification of ovarian tumors.","volume":"97","author":"Chen","year":"2003","journal-title":"Cancer."},{"key":"B12","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.2214\/ajr.171.4.9762997","article-title":"Cystic teratomas of the ovary: diagnostic value of sonography.","volume":"171","author":"Patel","year":"1998","journal-title":"AJR Am J Roentgenol."},{"key":"B13","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1148\/radiology.155.2.3885313","article-title":"Cystic ovarian teratomas: the sonographic appearance of the dermoid plug.","volume":"155","author":"Quinn","year":"1985","journal-title":"Radiology."},{"key":"B14","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1002\/uog.24904","article-title":"Imaging in gynecological disease (24): clinical and ultrasound characteristics of ovarian mature cystic teratomas.","volume":"60","author":"Heremans","year":"2022","journal-title":"Ultrasound Obstet Gynecol."},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2022.101662","article-title":"Artificial intelligence performance in image-based ovarian cancer identification: a systematic review and meta-analysis.","volume":"53","author":"Xu","year":"2022","journal-title":"EClinicalMedicine."},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1133491","article-title":"AI diagnostic performance based on multiple imaging modalities for ovarian tumor: a systematic review and meta-analysis.","volume":"13","author":"Ma","year":"2023","journal-title":"Front Oncol."},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1186\/s13244-022-01345-x","article-title":"Analysis of computer-aided diagnostics in the preoperative diagnosis of ovarian cancer: a systematic review.","volume":"14","author":"Koch","year":"2023","journal-title":"Insights Imaging."},{"key":"B18","doi-asserted-by":"crossref","first-page":"837","DOI":"10.2307\/2531595","article-title":"Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach.","volume":"44","author":"DeLong","year":"1988","journal-title":"Biometrics."},{"key":"B19","article-title":"An international terminology for endometriosis.","volume":"2021","author":"Tomassetti","year":"2021","journal-title":"Hum Reprod Open."},{"key":"B20","doi-asserted-by":"crossref","DOI":"10.1093\/hropen\/hoac009","article-title":"ESHRE guideline: endometriosis.","volume":"2022","author":"Becker","year":"2022","journal-title":"Hum Reprod Open."},{"key":"B21","doi-asserted-by":"crossref","DOI":"10.3390\/jcm12051858","article-title":"Expectant, medical, and surgical management of ovarian endometriomas.","volume":"12","author":"Muzii","year":"2023","journal-title":"J Clin Med"},{"key":"B22","doi-asserted-by":"crossref","first-page":"2293","DOI":"10.1007\/s00261-020-02873-0","article-title":"Ovarian teratomas: clinical features, imaging findings and management.","volume":"46","author":"Saleh","year":"2021","journal-title":"Abdom Radiol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1016\/s0015-0282(97)00228-8","article-title":"The growth pattern of ovarian dermoid cysts: a prospective study in premenopausal and postmenopausal women.","volume":"68","author":"Caspi","year":"1997","journal-title":"Fertil Steril."},{"key":"B24","doi-asserted-by":"publisher","first-page":"586","DOI":"10.1002\/uog.18961","article-title":"Transvaginal ultrasound vs magnetic resonance imaging for diagnosing deep infiltrating endometriosis: systematic review and meta-analysis.","volume":"51","author":"Guerriero","year":"2018","journal-title":"Ultrasound Obstet Gynecol."},{"key":"B25","doi-asserted-by":"publisher","first-page":"1549","DOI":"10.1148\/rg.2019190045","article-title":"Transvaginal US of endometriosis: looking beyond the endometrioma with a dedicated protocol.","volume":"39","author":"Collins","year":"2019","journal-title":"Radiographics."},{"key":"B26","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1148\/radiol.2015151169","article-title":"Radiomics: images are more than pictures. They are data.","volume":"278","author":"Gillies","year":"2016","journal-title":"Radiology."},{"key":"B27","doi-asserted-by":"crossref","DOI":"10.1101\/cshperspect.a039537","article-title":"Application of radiomics and artificial intelligence for lung cancer precision medicine.","volume":"11","author":"Tunali","year":"2021","journal-title":"Cold Spring Harb Perspect Med."},{"key":"B28","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1038\/nrclinonc.2017.141","article-title":"Radiomics: the bridge between medical imaging and personalized medicine.","volume":"14","author":"Lambin","year":"2017","journal-title":"Nat Rev Clin Oncol."},{"key":"B29","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1002\/uog.23530","article-title":"Ultrasound image analysis using deep neural networks for discriminating between benign and malignant ovarian tumors: comparison with expert subjective assessment.","volume":"57","author":"Christiansen","year":"2021","journal-title":"Ultrasound Obstet Gynecol."},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1186\/s13244-023-01412-x","article-title":"Machine learning combined with radiomics and deep learning features extracted from CT images: a novel AI model to distinguish benign from malignant ovarian tumors.","volume":"14","author":"Jan","year":"2023","journal-title":"Insights Imaging."},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1154200","article-title":"Deep convolutional neural networks for multiple histologic types of ovarian tumors classification in ultrasound images.","volume":"13","author":"Wu","year":"2023","journal-title":"Front Oncol."},{"key":"B32","doi-asserted-by":"publisher","first-page":"742","DOI":"10.1016\/j.ultrasmedbio.2015.11.014","article-title":"Ultrasound image discrimination between benign and malignant adnexal masses based on a neural network approach.","volume":"42","author":"Aramend\u00eda-Vidaurreta","year":"2016","journal-title":"Ultrasound Med Biol."},{"key":"B33","doi-asserted-by":"publisher","first-page":"e179","DOI":"10.1016\/S2589-7500(21)00278-8","article-title":"Deep learning-enabled pelvic ultrasound images for accurate diagnosis of ovarian cancer in China: a retrospective, multicentre, diagnostic study.","volume":"4","author":"Gao","year":"2022","journal-title":"Lancet Digit Health."},{"key":"B34","doi-asserted-by":"publisher","first-page":"3358","DOI":"10.1007\/s00330-019-06124-9","article-title":"Magnetic resonance imaging radiomics in categorizing ovarian masses and predicting clinical outcome: a preliminary study.","volume":"29","author":"Zhang","year":"2019","journal-title":"Eur Radiol."},{"key":"B35","doi-asserted-by":"crossref","first-page":"4960","DOI":"10.1007\/s00330-020-07266-x","article-title":"Evaluation of a convolutional neural network for ovarian tumor differentiation based on magnetic resonance imaging.","volume":"31","author":"Wang","year":"2021","journal-title":"Eur Radiol."},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14040987","article-title":"Diagnosing ovarian cancer on MRI: a preliminary study comparing deep learning and radiologist assessments.","volume":"14","author":"Saida","year":"2022","journal-title":"Cancers."},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.770683","article-title":"Application of deep convolutional neural networks for discriminating benign, borderline, and malignant serous ovarian tumors from ultrasound images.","volume":"11","author":"Wang","year":"2021","journal-title":"Front Oncol."},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1186\/s13048-022-00943-z","article-title":"Two-dimensional and three-dimensional T2 weighted imaging-based radiomic signatures for the preoperative discrimination of ovarian borderline tumors and malignant tumors.","volume":"15","author":"Liu","year":"2022","journal-title":"J Ovarian Res."},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14215291","article-title":"A deep learning model system for diagnosis and management of adnexal masses.","volume":"14","author":"Li","year":"2022","journal-title":"Cancers."},{"key":"B40","doi-asserted-by":"crossref","DOI":"10.3390\/medicina56100487","article-title":"Differentiation of endometriomas from ovarian hemorrhagic cysts at magnetic resonance: the role of texture analysis.","volume":"56","author":"Lupean","year":"2020","journal-title":"Medicina."},{"key":"B41","doi-asserted-by":"crossref","first-page":"1549","DOI":"10.1016\/j.jcmg.2019.06.009","article-title":"State-of-the-art deep learning in cardiovascular image analysis.","volume":"12","author":"Litjens","year":"2019","journal-title":"JACC Cardiovasc Imaging."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1362588\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T04:15:14Z","timestamp":1709871314000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1362588\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,8]]},"references-count":41,"alternative-id":["10.3389\/fmed.2024.1362588"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2024.1362588","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,8]]},"article-number":"1362588"}}