The influence of annotators' experience on radiomics-based machine learning performance in colorectal liver metastases characterization: Impact and mitigation strategy

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Authors: Roberto Francischello, Salvatore Claudio Fanni, Francesca Pia Caputo, Gayanè Aghakhanyan, Giacomo Aringhieri, Lorenzo Faggioni, Riccardo Antonio Lencioni, Emanuele Neri, Dania Cioni
Cited by: 1
References: 14

Abstract

Background Segmentation variability is a major source of bias in radiomics, yet its quantitative impact on downstream model performance remains poorly defined. This study aimed to assess how annotator expertise influences model generalization and to test a mitigation strategy based on a observer fingerprint correction. Methods An open-source CT dataset including 93 colorectal liver metastases with 46 desmoplastic and 47 replacement growth patterns was annotated independently by four observers with different expertise (radiologist, PhD student, two medical students). A standardized radiomics pipeline extracted 107 features and a machine-learning model was developed using nested cross-validation. Each model was evaluated in two setups: a standard pipeline with z-score normalization based on the training annotator, and a mitigation setup using external observer-specific normalization ("observer fingerprint"). Statistical comparisons used Wilcoxon signed-rank tests with rank-biserial correlation and common language effect size. Results In the first setup, the best performing test set annotator was the radiologist for both the models trained on radiologist, PhD and STUD1 annotations with an AUC-ROC median [IQR] of 0.79 [0.76, 0.81], 0.74 [0.70, 0.76], and 0.77 [0.74, 0.80] respectively. For the model trained on STUD2 annotations, PhD was the best test set annotator with an AUC-ROC of 0.72 [0.70, 074]. In the second setup, the best performing test set annotator was RAD for all the models. The mitigation strategy significantly increased median AUC-ROC in the majority of cross-annotator comparisons (p

Fields of Study & Subjects

Radiomics and Machine Learning in Medical Imaging Artificial Intelligence in Healthcare and Education Radiology practices and education

Publication details

Journal / source
European Journal of Radiology Artificial Intelligence
Publisher
Elsevier BV
Volume
6
Pages
100091–100091
Publication date
28 March 2026
Language
EN