Automatic ovarian tumors recognition system based on ensemble convolutional neural network with ultrasound imaging
Open accessAbstract
Background: Upon the discovery of ovarian cysts, obstetricians, gynecologists, and ultrasound examiners must address the common clinical challenge of distinguishing between benign and malignant ovarian tumors. Numerous types of ovarian tumors exist, many of which exhibit similar characteristics that increase the ambiguity in clinical diagnosis. Using deep learning technology, we aimed to develop a method that rapidly and accurately assists the different diagnosis of ovarian tumors in ultrasound images. Methods: Based on deep learning method, we used ten well-known convolutional neural network models (e.g., Alexnet, GoogleNet, and ResNet) for training of transfer learning. To ensure method stability and robustness, we repeated the random sampling of the training and validation data ten times. The mean of the ten test results was set as the final assessment data. After the training process was completed, the three models with the highest ratio of calculation accuracy to time required for classification were used for ensemble learning pertaining. Finally, the interpretation results of the ensemble classifier were used as the final results. We also applied ensemble gradient-weighted class activation mapping (Grad-CAM) technology to visualize the decision-making results of the models. Results: The highest mean accuracy, mean sensitivity, and mean specificity of ten single CNN models were 90.51 ± 4.36%, 89.77 ± 4.16%, and 92.00 ± 5.95%, respectively. The mean accuracy, mean sensitivity, and mean specificity of the ensemble classifier method were 92.15 ± 2.84%, 91.37 ± 3.60%, and 92.92 ± 4.00%, respectively. The performance of the ensemble classifier is better than that of a single classifier in three evaluation metrics. Moreover, the standard deviation is also better which means the ensemble classifier is more stable and robust. Conclusion: From the comprehensive perspective of data quantity, data diversity, robustness of validation strategy, and overall accuracy, the proposed method outperformed the methods used in previous studies. In future studies, we will continue to increase the number of authenticated images and apply our proposed method in clinical settings to increase its robustness and reliability.
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Hsu et al. distinguished between transabdominal and transvaginal US images.
“Hsu et al. distinguished between transabdominal and transvaginal US images [185].”
From Evolving the Era of 5D Ultrasound? A Systematic Literature Review on the Applications for Artificial Intelligence Ultrasound Imaging in Obstetrics and Gynecology (2023) · cites this paper as [185]
The Methods (Database; page unavailable) say Hsu et al. included both abdominal and vaginal ultrasound images, but do not say they separated them. The Conclusion (page unavailable) states that no study had attempted to distinguish the two image types during data collection and proposes addressing their different features in future work. (LLM, conf=0.88)
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Experimental — accuracy not yet measuredSmall sample sizes not sufficient enough to train the algorithm was a frequent limitation.
“small sample sizes not sufficient enough to train the algorithm [184,185,187,188,192,193].”
From Evolving the Era of 5D Ultrasound? A Systematic Literature Review on the Applications for Artificial Intelligence Ultrasound Imaging in Obstetrics and Gynecology (2023) · cites this paper as [185]
The Methods (Database, Preprocessing; page unavailable) describe augmenting the training images, and the Conclusion (page unavailable) says more patient images would increase data diversity. The paper does not say its sample was insufficient to train the algorithm or characterize small samples as a frequent limitation. (LLM, conf=0.78)
Experimental — accuracy not yet measuredAutomated discrimination between benign and malignant tumors was a predominant focus of the current research, represented in six included studies.
“Enabling an automated discrimination between benign and malignant tumors was a predominant focus of the current research, represented in six studies included [185,186,187,188,189,190].”
A change in US probe or modality may lead to misclassification.
“A change in US probe or modality may also lead to misclassification, e.g., when comparing abdominal or vaginal US images [185].”
Of the 11 extracted articles on gynecologic AI US, only two were designed as prospective studies.
“Of the 11 extracted articles, only two were designed as prospective studies [184,185].”
From Evolving the Era of 5D Ultrasound? A Systematic Literature Review on the Applications for Artificial Intelligence Ultrasound Imaging in Obstetrics and Gynecology (2023) · cites this paper as [185]
The Methods > Database section (page unavailable) describes an ovarian-ultrasound AI study using images from 587 patients, but does not say whether it was prospectively designed. Searches for prospective recruitment and study design found no passage establishing that designation; this paper also cannot establish the citing review’s count of two among 11 articles. (LLM, conf=0.72)
Experimental — accuracy not yet measured
The findings of Gao et al. were consistent with other studies.
“These findings were consistent with other studies [185,186]”
From Evolving the Era of 5D Ultrasound? A Systematic Literature Review on the Applications for Artificial Intelligence Ultrasound Imaging in Obstetrics and Gynecology (2023) · cites this paper as [185]
The Discussion compares Hsu et al.’s ovarian-ultrasound classification results with several earlier studies, but it does not identify Gao et al.’s findings or say whether they were consistent with its own. Searches for Gao and for consistency with other studies did not establish the claimed relationship. (LLM, conf=0.70)
Experimental — accuracy not yet measured
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References 37 · Cited by 58
Research works printed but not linked: 3
- [8]Shoeibi A, Khodatars M, Alizadehsani R, Ghassemi N, Jafari M, Moridian P, Khadem A, Sadeghi D, Hussain S, Zare A. Automated detection and forecasting of covid-19 using deep learning techniques: a review. arXiv preprint arXiv:200710785 2020.
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- Authors
- Hsu, S.-T., Su, Y.-J., Hung, C.-H., Chen, M.-J., Lu, C.-H., & Kuo, C.-E.
- Affiliations
- Taichung Veterans General Hospital (TW)
- National Chung Hsing University (TW)
- Corresponding author
- Kuo, Chih-En
- Venue
- BMC Medical Informatics and Decision Making
- Published
- 2022-11-17
- Volume
- 22
- Issue
- 1
- Pages
- 298-298
- ISSN
- 1472-6947 (ISSN-L)
- PMC
- PMC9673368
- OpenAlex
- W4309517808
- Cited by
- 58
- References
- 37
- Citations by year
- 2026: 11 · 2025: 14 · 2024: 24 · 2023: 9
- FWCI
- 3.95
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Medical Informatics and Decision Making (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Science Council
- Taichung Veterans General Hospital (TCVGH-AI-11002, TCVGH-AI-10903)
- Topics
- Physical Sciences › Computer Science › Artificial Intelligence › AI in cancer detection
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiomics and Machine Learning in Medical Imaging
- Health Sciences › Medicine › Reproductive Medicine › Ovarian cancer diagnosis and treatment
- Keywords
- ovarian neoplasms, ovarian cysts, benign versus malignant differentiation, ultrasonography, ensemble convolutional neural networks, transfer learning, Grad-CAM, decision visualization, computer-aided diagnosis, deep learning
- MeSH terms
- Diagnosis, Differential, Female, Humans, Ovarian Neoplasms, Ultrasonography, Reproducibility of Results, Neural Networks, Computer
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