Radiomics model based on computed tomography images for prediction of radiation-induced optic neuropathy following radiotherapy of brain and head and neck tumors.

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We aimed to build a machine learning-based model to predict radiation-induced optic neuropathy in patients who had treated head and neck cancers with radiotherapy. To measure radiation-induced optic neuropathy, the visual evoked potential values were obtained in both case and control groups and compared. Radiomics features were extracted from the area segmented which included the right and left optic nerves and chiasm. We integrated CT image features with dosimetric and clinical data subsequently, ranked 5 supervised ML models Bernoulli Naive Bayes, Decision Tree, Gradient Boosting Decision Trees, K-Nearest Neighbor, and Random Forest on 4 input datasets to predict radiation-induced visual complications classifiers by implementing 5-fold cross-validation. The F1 score, accuracy, sensitivity, specificity, and area under the ROC curve were compared to access prediction capability. radiation-induced optic neuropathy affected 31% of the patients. 856 radiomic characteristics were extracted and selected from each segmented area. Decision Tree and Random Forest with the highest AUC (97% and 95% respectively) among the five classifiers were the most powerful algorithms to predict radiation-induced optic neuropathy. Chiasm with higher sensitivity and precision was able to predict radiation-induced optic neuropathy better than right or left optic nerve or combination of all radiomic features. We found that combination of radiomic, dosimetric, and clinical factors can predict radiation-induced optic neuropathy after radiation treatment with high accuracy. To acquire more reliable results, it is recommended to conduct visual evoked potential tests before and after radiation therapy, with multiple follow-up courses and more patients.