Open this publication in new window or tab >>KTH, School of Electrical Engineering and Computer Science (EECS), Computer Science, Computational Science and Technology (CST). KTH, Centres, Science for Life Laboratory, SciLifeLab.
Department of Gynecological Oncology and Gynecology, Medical University of Lublin, Lublin, Poland.
Unit of Obstetrics & Gynecology, Department of Biomedical and Clinical Sciences, Luigi Sacco University Hospital, University of Milan, Milan, Italy.
Institute for the Care of Mother and Child, Prague, Czech Republic; Third Faculty of Medicine, Charles University, Prague, Czech Republic.
Department of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy; UO Gynecology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
Department of Obstetrics and Gynaecology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Unit of Preventive Gynecology, European Institute of Oncology IRCCS, Milan, Italy.
Gynecologic Oncology Centre, Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.
Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy.
Obstetrics and Gynecology Unit, Forlì and Faenza Hospitals, AUSL Romagna, Forlì, Italy.
Department of Obstetrics, Gynecology, and Reproduction, Dexeus University Hospital, Barcelona, Spain.
Department of Perinatology and Oncological Gynecology, Faculty of Medical Sciences, Medical University of Silesia, Katowice, Poland.
Centro Integrato di Procreazione Medicalmente Assistita e Diagnostica Ostetrico-Ginecologica, Azienda Ospedaliero Universitaria-Policlinico Duilio Casula, Monserrato, University of Cagliari, Cagliari, Italy.
Institute for Maternal and Child Health, IRCCS ‘Burlo Garofolo’, Trieste, Italy.
Department of Obstetrics and Gynecology, Skåne University Hospital, Lund, Sweden.
Section of Obstetrics and Gynecology, Department of Clinical Sciences, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria delle Marche, Ancona, Italy.
Department of Obstetrics and Gynecology, Clínica Universidad de Navarra, Pamplona, Spain.
First Department of Obstetrics and Gynecology, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Department of Obstetrics and Gynecology, Rizal Medical Center, Manila, Philippines.
Unit of Obstetrics & Gynecology, Department of Biomedical and Clinical Sciences, Luigi Sacco University Hospital, University of Milan, Milan, Italy.
Gynecologic and Obstetric Unit, Women’s and Children’s Department, Forlì Hospital, Forlì, Italy.
Gynecologic Oncology Centre, Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.
Gynecology and Breast Care Center, Mater Olbia Hospital, Olbia, Italy.
Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy.
KTH, School of Electrical Engineering and Computer Science (EECS), Computer Science, Computational Science and Technology (CST). KTH, School of Electrical Engineering and Computer Science (EECS), Centres, Digital futures.
KTH, Centres, Science for Life Laboratory, SciLifeLab. KTH, School of Electrical Engineering and Computer Science (EECS), Computer Science, Computational Science and Technology (CST).
Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Department of Obstetrics and Gynecology, Södersjukhuset, Stockholm, Sweden.
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2025 (English)In: Nature Medicine, ISSN 1078-8956, E-ISSN 1546-170X, Vol. 31, no 1, p. 189-196Article in journal (Refereed) Published
Abstract [en]
Ovarian lesions are common and often incidentally detected. A critical shortage of expert ultrasound examiners has raised concerns of unnecessary interventions and delayed cancer diagnoses. Deep learning has shown promising results in the detection of ovarian cancer in ultrasound images; however, external validation is lacking. In this international multicenter retrospective study, we developed and validated transformer-based neural network models using a comprehensive dataset of 17,119 ultrasound images from 3,652 patients across 20 centers in eight countries. Using a leave-one-center-out cross-validation scheme, for each center in turn, we trained a model using data from the remaining centers. The models demonstrated robust performance across centers, ultrasound systems, histological diagnoses and patient age groups, significantly outperforming both expert and non-expert examiners on all evaluated metrics, namely F1 score, sensitivity, specificity, accuracy, Cohen’s kappa, Matthew’s correlation coefficient, diagnostic odds ratio and Youden’s J statistic. Furthermore, in a retrospective triage simulation, artificial intelligence (AI)-driven diagnostic support reduced referrals to experts by 63% while significantly surpassing the diagnostic performance of the current practice. These results show that transformer-based models exhibit strong generalization and above human expert-level diagnostic accuracy, with the potential to alleviate the shortage of expert ultrasound examiners and improve patient outcomes.
Place, publisher, year, edition, pages
Springer Nature, 2025
National Category
Cancer and Oncology Computer graphics and computer vision
Identifiers
urn:nbn:se:kth:diva-371960 (URN)10.1038/s41591-024-03329-4 (DOI)001388159800001 ()39747679 (PubMedID)2-s2.0-85214010322 (Scopus ID)
Note
Not duplicate with diva 1905526
QC 20251022
2025-10-222025-10-222025-10-22Bibliographically approved