Evidence map›Paper›PMID 39869553›Full record

ArticlePloS one2025

Distinguishing benign and malignant myxoid soft tissue tumors: Performance of radiomics vs. radiologists.

Joshua M Lawrenz, Can Cui, Samuel R Johnson, Katherine S Hajdu, Stephen W Chenard, Akhil Rekulapelli, Cullen P Moran, John J Block, Nicholson S Chadwick, Joanna L Shechtel and 8 more

Abstract readComparative Study
In one paragraph

Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Joshua M LawrenzDepartment of Orthopaedic Surgery, Division of Musculoskeletal Oncology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America.ORCID 0000-0003-4069-7044
Can CuiVanderbilt Institute of Surgery and Engineering, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America.
Samuel R JohnsonDepartment of Orthopaedic Surgery, Division of Musculoskeletal Oncology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America.
Katherine S HajduDepartment of Orthopaedic Surgery, Division of Musculoskeletal Oncology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America.
Stephen W ChenardDepartment of Orthopaedic Surgery, Division of Musculoskeletal Oncology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America.ORCID 0000-0003-1029-7015
Akhil RekulapelliDepartment of Orthopaedic Surgery, Division of Musculoskeletal Oncology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America.
Cullen P MoranDepartment of Orthopaedic Surgery, Division of Musculoskeletal Oncology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America.
John J BlockDepartment of Radiology, Division of Musculoskeletal Radiology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America.
Nicholson S ChadwickDepartment of Radiology, Division of Musculoskeletal Radiology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America.
Joanna L ShechtelDepartment of Radiology, Division of Musculoskeletal Radiology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America.
Brian BinghamDepartment of Radiation Oncology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America.
Leo Y LuoDepartment of Radiation Oncology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America.
Jennifer L HalpernDepartment of Orthopaedic Surgery, Division of Musculoskeletal Oncology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America.
Herbert S SchwartzDepartment of Orthopaedic Surgery, Division of Musculoskeletal Oncology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America.
Ginger E HoltDepartment of Orthopaedic Surgery, Division of Musculoskeletal Oncology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America.
David S SmithDepartment of Radiology, Division of Musculoskeletal Radiology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America.
Benoit DawantVanderbilt Institute of Surgery and Engineering, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America.
Hakmook KangDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America.ORCID 0000-0001-6876-4021

Funding

Vanderbilt Clinical Oncology Research Career Development ProgramK12CA090625 · NCI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Debra L. Friedman, Paula Jill Hurley · 2001 to 2026
$16.9M
NCI NIH HHS K12 CA090625
6 · The paper itself

Abstract

introductionBenign and malignant myxoid soft tissue tumors have shared clinical, imaging, and histologic features that can make diagnosis challenging. The purpose of this study is comparison of the diagnostic performance of a radiomic based machine learning (ML) model to musculoskeletal radiologists.

methodsManual segmentation of 90 myxoid soft tissue tumors (45 myxomas and 45 myxofibrosarcomas) was performed on axial T1, and T2FS or STIR magnetic resonance imaging sequences. Eighty-seven radiomic features from each modality were extracted. Five ML models were trained to classify tumors as benign or malignant in 40 tumors and then tested with an additional 50 tumors using cross validation. The accuracy of the best ML model based on area under the receiver operating characteristic curve (AUC) was compared to the consensus diagnosis of three musculoskeletal radiologists. Correlation between radiologist confidence (equivocal, probably, consistent with) and accuracy was tested.

resultsThe best ML classifier was a logistic regression model (AUC 0.792). Using T1 + T2/STIR images, the ML model classified 78% (39/50) of tumors correctly at a similar rate compared to 74% (37/50) by radiologists. When radiologists disagreed, the consensus diagnosis classified 50% of tumors (7/14) correctly compared to 86% (12/14) by the ML model, though this did not reach statistical significance. Radiologists had a cumulative accuracy of 91% (30/33) when they rated their confidence 'consistent with' compared to 61% (31/51) when they rated their confidence 'equivocal/probably' (P = 0.006). For cases when radiologists rated their confidence 'equivocal/probably', the ML model had 76% accuracy (39/51).

conclusionsA radiomic based ML model predicted benign or malignant diagnosis in myxoid soft tissue tumors similarly to the consensus diagnosis by three musculoskeletal radiologists. Radiologist confidence in the diagnosis strongly correlated with their diagnostic accuracy. Though radiomics and radiologists perform similarly overall, radiomics may provide novel diagnostic utility when radiologist confidence is low, or when radiologists disagree.

Indexed as

MyxomaRadiologistsSoft Tissue NeoplasmsAdultAgedDiagnosis, DifferentialFemaleHumansMachine LearningMagnetic Resonance ImagingMaleMiddle AgedRadiomicsROC Curve

Identifiers

PMID39869553
PMCPMC11771854

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