A multimodal uncertainty-aware AI system optimizes ovarian cancer risk assessment workflow
Accurate ovarian cancer screening and diagnosis are critical for patient survival. We present UMORSS, an AI-assisted diagnostic system integrating ultrasound (US) imaging and clinical data with uncertainty quantification for precise ovarian cancer risk assessment. Developed and evaluated using a multicentre dataset (7352 patients, 7594 lesions, 9281 US images), UMORSS employs a two-phase approach: Phase I rapidly triages low-risk lesions via initial US analysis, and Phase II provides uncertainty-aware multimodal analysis for complex cases. Phase I accurately identified 68.7% of physiological cysts and 13.8% of benign tumours as low-risk, with zero false negatives, and Phase II achieved an AUC of 0.955 (internal testing) and 0.926 (external validation). Furthermore, a prospective reader study (n = 284 cases, six radiologists) demonstrated that UMORSS as a human-AI collaborative tool increased radiologists' average AUC by 10.58% and sensitivity by 22.48%. UMORSS shows strong potential to streamline clinical workflow, optimize resource allocation, and standardize ovarian cancer diagnosis.
Authors
- Ruiyu Zhao
- Xiaohui Lv (ORCID: https://orcid.org/0009-0008-7404-1776)
- Xiyang Liu (ORCID: https://orcid.org/0000-0001-5214-3677)
- Lirong Ai
- Zijun Chen (ORCID: https://orcid.org/0000-0001-7464-4755)
- Yanli Zhu - (ORCID: https://orcid.org/0009-0008-4778-4646)
- Li‐Ping Zou (ORCID: https://orcid.org/0000-0001-7233-9378)
- Min Zhao (ORCID: https://orcid.org/0000-0002-1335-4495)
- Long Zhao (ORCID: https://orcid.org/0000-0003-1710-4431)
- Liming Wang (ORCID: https://orcid.org/0000-0002-4178-3537)
- M. Liu (ORCID: https://orcid.org/0000-0003-0056-7296)
- Bing Zhang (ORCID: https://orcid.org/0000-0003-2108-9553)
- Xinlei Zhang (ORCID: https://orcid.org/0000-0003-2281-3363)
- Hong Yang (ORCID: https://orcid.org/0000-0002-5355-0829)
- Xin Shi (ORCID: https://orcid.org/0000-0003-1198-2882)
- Xiaodong Wang (ORCID: https://orcid.org/0009-0006-5098-1734)
- Yane Gao
- Jingwen Wang (ORCID: https://orcid.org/0000-0002-1484-201X)
- Jiahao Zhang (ORCID: https://orcid.org/0009-0001-4571-5427)
Institutions
- Xidian University (CN)
- Northwestern Polytechnical University (CN)
- The Fourth People's Hospital (CN)
- Xi'an Medical University (CN)
- Second Affiliated Hospital of Xi'an Jiaotong University (CN)
- Xi’an Children’s Hospital (CN)
- Xijing Hospital (CN)
- First Hospital of Xi'an (CN)
- Air Force Medical University (CN)
Publication Details
- Journal
- npj Digital Medicine
- Published
- 2025-10-16
- DOI
- https://doi.org/10.1038/s41746-025-01986-4
- Citations
- 3
- Primary Topic
- Ovarian cancer diagnosis and treatment
- Type
- article
- Field-Weighted Citation Impact
- 5.09
Funders
- National Natural Science Foundation of China
- Xidian University
- Natural Science Foundation of Shaanxi Province