Fig. 1.

Schematic workflow of the proposed US-guided targeted biopsies of distinct CT-based radiomic tumour phenotypes. Standard-of-care contrast-enhanced (CE) CTs were used to manually segment US targetable tumour deposits in the pelvis or omentum. Automated tissue sub-segmentation was applied in selected omental lesions to remove non-tumoural fatty tissue at the segmentation edges. Spatial radiomic features were computed and the Gaussian mixture modelling clustering was applied to identify up to three habitats per tumour lesion. Habitat maps were exported and manually uploaded together with the source CT data to a US machine. Up to two biopsies per habitat were obtained and used for clinical diagnosis, as well as for research purposes