Differential diagnosis of benign and lung adenocarcinoma presenting as larger solid nodules and masses based on multiscale CT radiomics.

Abstract

To develop a better radiomic model for the differential diagnosis of benign and lung adenocarcinoma lesions presenting as larger solid nodules and masses based on multiscale computed tomography (CT) radiomics. This retrospective study enrolled 205 patients with solid nodules and masses from Center 1 between January 2010 and February 2022 and Center 2 between January 2019 and February 2022. After applying the inclusion and exclusion criteria, we retrospectively enrolled 165 patients from two centers and assigned them to the training dataset (n = 115) or the test dataset (n = 50). Radiomics features were extracted from volumes of interest on CT images. A gradient boosting decision tree (GBDT) was used for data dimensionality reduction to perform the final feature selection. Four models were developed using clinical data, conventional imaging features and radiomics features, namely, the clinical and image model (CIM), the plain CT radiomics model (PRM), the enhanced CT radiomics model (ERM) and the combined model (CM). Model performance was evaluated to determine the best model for identifying benign and lung adenocarcinoma presenting as larger solid nodules and masses. In the training dataset, the areas under the curve (AUCs) for the CIM, PRM, ERM, and CM were 0.718, 0.806, 0.819, and 0.917, respectively. The differential diagnostic capability of the ERM was better than that of the PRM and the CIM. The CM was optimal. Intermediate and junior radiologists and respiratory physicians achieved improved obviously diagnostic results with the radiomics model. The senior radiologists showed slight improved diagnostic results after using the radiomics model. Radiomics may have the potential to be used as a noninvasive tool for the differential diagnosis of benign and lung adenocarcinoma lesions presenting as larger solid nodules and masses.