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Predicting High-Grade Patterns in Stage I Solid Lung Adenocarcinoma: A Study of 371 Patients Using Refined Radiomics
Hong Zheng1, Wei Chen2, Jun Liu1
1Department of Radiology, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, China.
Introduction:
This study aimed to devise a diagnostic algorithm, termed the Refined Radiomics and Deep Learning Features-Guided CatBoost Classifier (RRDLC-Classifier), and evaluate its efficacy in predicting pathological high-grade patterns in patients diagnosed with clinical stage I solid lung adenocarcinoma (LADC).
Methods:
In this retrospective study, a total of 371 patients diagnosed with clinical stage I solid LADC were randomly categorized into training and validation sets in a 7:3 ratio. Uni- and multivariate logistic regression analyses were performed to examine the imaging findings that can be used to predict pathological high-grade patterns meticulously. Employing redundancy and the least absolute shrinkage and selection operator regression, a radiomics model was developed. Subsequently, radiomics refinement and deep learning features were employed using a machine learning algorithm to construct the RRDLC-Classifier, which aims to predict high-grade patterns in clinical stage I solid LADC. Evaluation metrics, such as receiver operating characteristic curves, areas under the curve (AUCs), accuracy, sensitivity, and specificity, were computed for assessment.
Results:
The RRDLC-Classifier attained the highest AUC of 0.838 (95% confidence interval [CI]: 0.766-0.911) in predicting high-grade patterns in clinical stage I solid LADC, followed by radiomics with an AUC of 0.779 (95% CI: 0.675-0.883), and imaging findings with an AUC of 0.6 (95% CI: 0.472-0.726).
Conclusions:
This study introduces the RRDLC-Classifier, a novel diagnostic algorithm that amalgamates refined radiomics and deep learning features to predict high-grade patterns in clinical stage I solid LADC. This algorithm may exhibit excellent diagnostic performance, which can facilitate its application in precision medicine.

