biostudies-literatureWang XKey Research and Development Projects of Shaanxi ProvinceNatural Science Foundation of ChinaNatural Science Foundation of Shaanxi Province, ChinaShaanxi Provincial InnovationNational Natural Science Foundation of ChinaShaanxi Provincial Key Industry Innovation Chain614https://www.ebi.ac.uk/biostudies/studies/S-EPMC12533055biostudies-literatureUnknown8(1)Accurate ovarian cancer screening and diagnosis are critical for patient survival. We present UMORSS, an AI-assisted diagnostic system integrating ultrasound (US) imaging and clinical data with uncertainty quantification for precise ovarian cancer risk assessment. Developed and evaluated using a multicentre dataset (7352 patients, 7594 lesions, 9281 US images), UMORSS employs a two-phase approach: Phase I rapidly triages low-risk lesions via initial US analysis, and Phase II provides uncertainty-aware multimodal analysis for complex cases. Phase I accurately identified 68.7% of physiological cysts and 13.8% of benign tumours as low-risk, with zero false negatives, and Phase II achieved an AUC of 0.955 (internal testing) and 0.926 (external validation). Furthermore, a prospective reader stuNPJ digital medicineA multimodal uncertainty-aware AI system optimizes ovarian cancer risk assessment workflow.PMC125330552024JC-ZDXM-522024SF-ZDCYL-01-172023PT-078217299382172860821030372022ZDLSF04-04Yang HZou LZhang JZhu YLiu MLv XAi LWang JShi XWang LLiu XZhao MZhao LChen ZZhao RZhang XGao YWang XZhang BfalseA multimodal uncertainty-aware AI system optimizes ovarian cancer risk assessment workflow.Accurate ovarian cancer screening and diagnosis are critical for patient survival. We present UMORSS, an AI-assisted diagnostic system integrating ultrasound (US) imaging and clinical data with uncertainty quantification for precise ovarian cancer risk assessment. Developed and evaluated using a multicentre dataset (7352 patients, 7594 lesions, 9281 US images), UMORSS employs a two-phase approach: Phase I rapidly triages low-risk lesions via initial US analysis, and Phase II provides uncertainty-aware multimodal analysis for complex cases. Phase I accurately identified 68.7% of physiological cysts and 13.8% of benign tumours as low-risk, with zero false negatives, and Phase II achieved an AUC of 0.955 (internal testing) and 0.926 (external validation). Furthermore, a prospective reader stu2025-01-01T00:00:00Z2025 Oct2026-06-04T14:25:49.532Z2026-05-10T03:11:26.623ZS-EPMC125330554110239010.1038/s41746-025-01986-4