Deep Learning Radiomics Model Based on Ultrasound Images Predicts Myometrial Infiltration of Endometrial Cancer
Clinical Snapshot
PICO Framework
| P — Population | 390 patients with endometrial cancer undergoing surgical resection (310 from center 1, 80 from center 2) |
| I — Intervention | Deep learning radiomics (DLR) model based on ultrasound images |
| C — Comparator | Radiomics model alone, deep learning model alone, and advanced ultrasound physician assessment |
| O — Outcomes | Accuracy of predicting myometrial infiltration depth (sensitivity, specificity, AUC) |
Bottom Line
This diagnostic accuracy study evaluated a deep learning radiomics model for predicting myometrial infiltration in endometrial cancer using ultrasound images. While the model showed promising AUC values (0.87-0.84) across validation and external testing sets, the study has significant methodological limitations. Critical diagnostic accuracy measures like sensitivity and specificity are missing, methodological details are insufficient for reproducibility, and blinding procedures are unclear. The clinical utility of myometrial infiltration assessment is well-established for surgical planning, but this model requires more rigorous validation with complete diagnostic accuracy reporting before clinical implementation. The external validation is encouraging, but the wide confidence intervals and limited sample size warrant cautious interpretation.
Key Findings
P Value: Not reported
Effect Size: AUC 0.874 (validation set), AUC 0.844 (external testing set)
Primary Outcome: Area under the receiver operating characteristic curve for predicting myometrial infiltration
Nnt Or Sensitivity: Sensitivity and specificity not reported; only AUC values provided
Confidence Interval: 0.774-0.949 (validation), 0.699-0.957 (testing)
Clinical Application
Requires specialized deep learning infrastructure and ultrasound expertise; model validation needed before clinical implementation Could complement MRI staging under Medicare if validated; relevant to gynecologic oncology units and specialist ultrasound services Women with endometrial cancer requiring pre-operative staging assessment
Abstract
OBJECTIVE: This study aims to develop and validate a deep learning radiomics (DLR) model based on ultrasound images for non-invasively distinguishing the myometrial infiltration (MI) of patients with endometrial cancer (EC). METHODS: We retrospectively collected 310 patients with EC who underwent surgical resection from center 1 from September 2017 to January 2025, forming a training group and a validation group. An external testing group was comprised of 80 patients from center 2. We extracted deep learning (DL) features and radiomics features from ultrasound images, establishing a DLR model after dimensionality reduction. The receiver operating characteristic analysis was used to evaluate the practicality of the proposed model. The utility of the proposed model was evaluated using receiver operating characteristic, calibration, and decision curve analysis. RESULTS: A total of 390 EC patients were included in the study. In the validation set, the AUC of the radiomics model was 0.874 (0.774-0.949), and in the testing group, the AUC of the DL model was 0.844 (0.699-0.957). The DLR model was superior to radiomics models and DL models in interpreting images, and also outperformed the diagnostic performance of advanced ultrasound physicians. CONCLUSION: The DLR model based on ultrasound images can accurately and non-invasively distinguish the MI depth of EC patients, assisting doctors in formulating more favorable treatment plans for patients.
References
- 1.Guo, Y., Chen, J., Luo, Y., & Huang, J. (2026). Deep Learning Radiomics Model Based on Ultrasound Images Predicts Myometrial Infiltration of Endometrial Cancer. Journal of Clinical Ultrasound, Article jcu.70134. https://doi.org/10.1002/jcu.70134
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