磁共振成像2026，Vol.17Issue(4)：79-87,9.DOI:10.12015/issn.1674-8034.2026.04.011
基于磁共振成像影像组学的肿瘤内异质性评分模型在卵巢肿瘤恶性风险评估中的应用价值
Utility of an MRI-based radiomics intratumoral heterogeneity scoring model for malignancy risk assessment of ovarian neoplasms
摘要
Abstract
Objective:To calculate an intratumoral heterogeneity(ITH)score using a magnetic resonance imaging(MRI)-based radiomics approach,to construct a preoperative malignancy risk assessment model for ovarian neoplasms by integrating clinical variables and conventional MRI features,and to evaluate its adjunctive value for risk stratification of Ovarian-Adnexal Reporting and Data System(O-RADS)MRI category 4 lesions and for diagnosis by junior physicians.Materials and Methods:This retrospective study included 120 patients with pathologically confirmed ovarian neoplasms,including 52 benign and 68 malignant tumors,the latter including borderline tumors.The patients were randomly assigned to a training set(n=84)and a test set(n=36)in a 7∶3 ratio.After preprocessing T2-weighted images with spectral attenuated inversion recovery fat suppression,intratumoral and 3-mm peritumoral regions of interest were delineated.Radiomics features were extracted using a sliding-window approach,and K-means clustering was used to calculate the ITH score and the combined ITH score.Clinical features,conventional MRI features,and ITH scores were integrated.After screening by univariable analysis and least absolute shrinkage and selection operator regression,independent predictors were identified by multivariable logistic regression to construct a clinical model,an intratumoral model,and a combined model,respectively.All lesions were scored according to O-RADS MRI,and O-RADS MRI category 4 lesions were further analyzed for risk stratification;the adjunctive value of the model for diagnosis by junior physicians was also evaluated.Results:The ITH score showed good intra-and interobserver agreement,with intra-class correlation coefficients of 0.86 and 0.84,respectively.Among the three models,the combined model based on the risk of ovarian malignancy algorithm(ROMA)index,tumor composition,and the combined ITH score achieved the highest diagnostic performance.In the test set,the areas under the receiver operating characteristic curve were 0.805[95％confidence interval(CT):0.662 to 0.948],0.867(95％CI:0.750 to 0.984),and 0.923(95％CT:0.827 to 0.994)for the clinical,intratumoral,and combined models,respectively.The overall diagnostic performance of the O-RADS MRI score was comparable to that of the combined model.In the subgroup analysis of category 4 lesions,the combined model showed potential for further risk stratification,with relatively high diagnostic accuracy and specificity.Conclusion:The combined model based on the ROMA index,tumor composition,and the combined ITH score showed the highest diagnostic performance for preoperative malignancy risk assessment of ovarian neoplasms.It also has the potential to stratify O-RADS MRI category 4 lesions and may assist clinicians in diagnosis.关键词
卵巢肿瘤/肿瘤异质性/影像组学/列线图/磁共振成像/卵巢-附件报告和数据系统/风险分层Key words
ovarian neoplasms/tumor heterogeneity/radiomics/nomogram/magnetic resonance imaging/Ovarian-Adnexal Reporting and Data System/risk stratification分类
医药卫生引用本文复制引用
国明君,张娣,范华,谭淑宇,孙思雨,张传臣..基于磁共振成像影像组学的肿瘤内异质性评分模型在卵巢肿瘤恶性风险评估中的应用价值[J].磁共振成像,2026,17(4):79-87,9.基金项目
国家自然科学基金(编号:62476155) （编号:62476155）
山东省医药卫生科技项目(编号:202309011571)National Natural Science Foundation of China(No.62476155) （编号:202309011571）
Shandong Provincial Medical and Health Technology Project(No.202309011571). （No.202309011571）
