European Radiology

, Volume 29, Issue 7, pp 3358–3371 | Cite as

Magnetic resonance imaging radiomics in categorizing ovarian masses and predicting clinical outcome: a preliminary study

  • He Zhang
  • Yunfei Mao
  • Xiaojun Chen
  • Guoqing Wu
  • Xuefen Liu
  • Peng Zhang
  • Yu Bai
  • Pengcong Lu
  • Weigen Yao
  • Yuanyuan Wang
  • Jinhua YuEmail author
  • Guofu ZhangEmail author
Imaging Informatics and Artificial Intelligence



To evaluate the ability of MRI radiomics to categorize ovarian masses and to determine the association between MRI radiomics and survival among ovarian epithelial cancer (OEC) patients.


A total of 286 patients with pathologically proven adnexal tumor were retrospectively included in this study. We evaluated diagnostic performance of the signatures derived from MRI radiomics in differentiating (1) between benign adnexal tumors and malignancies and (2) between type I and type II OEC. The least absolute shrinkage and selection operator method was used for radiomics feature selection. Risk scores were calculated from the Lasso model and were used for survival analysis.


For the classification between benign and malignant masses, the MRI radiomics model achieved a high accuracy of 0.90 in the leave-one-out (LOO) cross-validation cohort and an accuracy of 0.87 in the independent validation cohort. For the classification between type I and type II subtypes, our method made a satisfactory classification in the LOO cross-validation cohort (accuracy = 0.93) and in the independent validation cohort (accuracy = 0.84). Low-high-high short-run high gray-level emphasis and low-low-high variance from coronal T2-weighted imaging (T2WI) and eccentricity from axial T1-weighted imaging (T1WI) images had the best performance in two classification tasks. The patients with higher risk scores were more likely to have poor prognosis (hazard ratio = 4.1694, p = 0.001).


Our results suggest radiomics features extracted from MRI are highly correlated with OEC classification and prognosis of patients. MRI radiomics can provide survival estimations with high accuracy.

Key Points

• The MRI radiomics model could achieve a higher accuracy in discriminating benign ovarian diseases from malignancies.

• Low-high-high short-run high gray-level emphasis, low-low-high variance from coronal T2WI, and eccentricity from axial T1WI had the best performance outcomes in various classification tasks.

• The ovarian cancer patients with high-risk scores had poor prognosis.


Ovarian epithelial cancer Magnetic resonance imaging Computer-assisted diagnosis Radiomics 



Apparent diffusion coefficient


Diffusion-weighted magnetic resonance imaging


International Federation of Gynecology and Obstetrics


Iterative sparse representation


Ovarian epithelial cancer


Picture archiving and communication system


System sparse representation coefficient


Support vector machine



This work is financially supported by the Shanghai Emerging Advanced Technology Joint Research Project (SHDC12014130).

Compliance with ethical standards


The scientific guarantor of this publication is Guofu Zhang.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

Statistician Yu Bai kindly provided all statistical work for this study.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.


• Retrospective

• Observational

• Performed at one institution

Supplementary material

330_2019_6124_MOESM1_ESM.docx (65 kb)
ESM 1 (DOCX 65 kb)


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Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  • He Zhang
    • 1
  • Yunfei Mao
    • 2
  • Xiaojun Chen
    • 3
  • Guoqing Wu
    • 2
  • Xuefen Liu
    • 1
  • Peng Zhang
    • 1
  • Yu Bai
    • 4
  • Pengcong Lu
    • 5
  • Weigen Yao
    • 5
  • Yuanyuan Wang
    • 2
  • Jinhua Yu
    • 2
    • 6
    Email author
  • Guofu Zhang
    • 1
    Email author
  1. 1.Department of Radiology, Obstetrics and Gynecology HospitalFudan UniversityShanghaiPeople’s Republic of China
  2. 2.Department of Electronic EngineeringFudan UniversityShanghaiPeople’s Republic of China
  3. 3.Department of Gynecology, Obstetrics and Gynecology HospitalFudan UniversityShanghaiPeople’s Republic of China
  4. 4.Center for Child and Family PolicyDuke UniversityDurhamUSA
  5. 5.Department of RadiologyYuyao People’s HospitalNingboPeople’s Republic of China
  6. 6.Key Laboratory of Medical Imaging Computing and Computer Assisted InterventionShanghaiPeople’s Republic of China

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