Unsupervised Approach for Malignancy Assessment of Lung Nodules in Computed Tomography Scans Using Radiomic Features

Lung cancer is the leading cause of cancer death worldwide. Early low-dose computed tomography (CT) screening can decrease its mortality rate and computer-aided diagnoses systems may make these screenings more accessible. Radiomic features and supervised machine learning have traditionally been employed in these systems. Contrary to supervised methods, unsupervised learning techniques do not require large amounts of annotated data which are labor-intensive to gather and long training times. Therefore, recent approaches have used unsupervised methods, such as clustering, to improve the performance of supervised models. However, an analysis of purely unsupervised methods for malignancy prediction of lung nodules from CT images has not been performed. This work studies nodule malignancy in the LIDC-IDRI image collection of chest CT scans using established radiomic features and unsupervised learning methods based on k-Means, Spectral Clustering, and Gaussian Mixture clustering. All tested methods resulted in clusters of high homogeneity malignancy. Results suggest convex feature distributions and well-separated feature subspaces associated with different diagnoses. Furthermore, diagnosis uncertainty may be explained by common characteristics captured by radiomic features. The k-Means and Gaussian Mixture models are able to generalize to unseen data, achieving a balanced accuracy of 87.23% and 86.96% when inference was tested. These results motivate the usage of unsupervised approaches for malignancy prediction of lung nodules, such as cluster-then-label models. Clinical Relevance- Unsupervised clustering of radiomic features of lung nodules in chest CT scans can differentiate between malignant and benign cases and reflects experts' diagnosis uncertainty.