Radiomic Machine Learning Classifiers in Spine Bone Tumors: A Multi-Software, Multi-Scanner Study

Purpose: Spinal lesion differential diagnosis remains challenging even in MRI. Radiomics and machine learning (ML) have proven useful even in absence of a standardized data mining pipeline. We aimed to assess ML diagnostic performance in spinal lesion differential diagnosis, employing radiomic data extracted by different software. Methods: Patients undergoing MRI for a vertebral lesion were retrospectively analyzed (n = 146, 67 males, 79 females; mean age 63 +/- 16 years, range 8-89 years) and constituted the train (n = 100) and internal test cohorts (n = 46). Part of the latter had additional prior exams which constituted a multi-scanner, external test cohort (n = 35). Lesions were labeled as benign or malignant (2-label classification), and benign, primary malignant or metastases (3-label classification) for classification analyses. Features extracted via 3D Slicer heterogeneityCAD module (hCAD) and PyRadiomics were independently used to compare different combinations of feature selection methods and ML classifiers (n = 19). Results: In total, 90 and 1548 features were extracted by hCAD and PyRadiomics, respectively. The best feature selection method-ML algorithm combination was selected by 10 iterations of 10-fold cross-validation in the training data. For the 2-label classification ML obtained 94% accuracy in the internal test cohort, using hCAD data, and 86% in the external one. For the 3-label classification, PyRadiomics data allowed for 80% and 69% accuracy in the internal and external test sets, respectively. Conclusions: MRI radiomics combined with ML may be useful in spinal lesion assessment. More robust preprocessing led to better consistency despite scanner and protocol heterogeneity.

Automated summary

The study evaluated the use of machine learning in spinal lesion differential diagnosis, utilizing radiomic data extracted by different software. By employing feature selection methods and ML classifiers, high accuracy was achieved in both internal and external test sets for two different classification scenarios, demonstrating the potential of MRI radiomics combined with machine learning in spinal lesion assessment.