MRI sub-regional radiomics of gluteus maximus predicts ovarian cancer recurrence

A MRI-based sub-regional radiomics model of gluteus maximus muscle/fat sub-regions predicted recurrence in high-grade serous ovarian cancer, achieving AUC 0.774 in validation; adding neoadjuvant chemo and PARP inhibitor status raised AUC to 0.817.

• Automatic U-Net segmentation of gluteus maximus on T2WI achieved Dice coefficients from 0.726 to 0.903 across cohorts.
• Sub-regional radiomics outperformed whole-ROI radiomics and deep learning models.
• The combined clinical-radiomics model was externally validated in three test sets with AUCs of 0.746, 0.799, and 0.733.

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