ABSTRACT
OBJECT: Epithelial Ovarian cancer (EOC) is the second most lethal gynecologic tumor in women. 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. METHODS: We included 58 patients with EOC with normal CA125 from two centers, who were confirmed by preoperative ultrasound and pathology. We extracted 1130 radiomics features based on the tumor'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. ROC curves judged their test efficacy. On the basis of the combined model, we developed a nomogram. RESULTS: 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 analyzing the calibration curves, it was determined that the nomogram matched actual observations in the training cohort. CONCLUSION: Ultrasound Radiomics Can Differentiate Type I and Type II EOC with Normal CA125 Levels. ADVANCES IN KNOWLEDGE: 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.