Differentiation of testicular seminomas from nonseminomas based on multiphase CT radiomics combined with machine learning: A multicenter study.

Differentiating seminomas from nonseminomas is crucial for formulating optimal treatment strategies for testicular germ cell tumors (TGCTs). Therefore, our study aimed to develop and validate a clinical-radiomics model for this purpose.

In this study, 221 patients with TGCTs confirmed by pathology from four hospitals were enrolled and classified into training (n = 126), internal validation (n = 55) and external test (n = 40) cohorts. Radiomics features were extracted from the CT images. After feature selection, we constructed a clinical model, radiomics models and clinical-radiomics model with different machine learning algorithms. The top-performing model was chosen utilizing receiver operating characteristic (ROC) curve analysis. Decision curve analysis (DCA) was also conducted to assess its practical utility.

Compared with those of the clinical and radiomics models, the clinical-radiomics model demonstrated the highest discriminatory ability, with AUCs of 0.918 (95 % CI: 0.870 - 0.966), 0.909 (95 % CI: 0.829 - 0.988) and 0.839 (95 % CI: 0.709 - 0.968) in the training, validation and test cohorts, respectively. Moreover, DCA confirmed that the combined model had a greater net benefit in predicting seminomas and nonseminomas.

The clinical-radiomics model serves as a potential tool for noninvasive differentiation between testicular seminomas and nonseminomas, offering valuable guidance for clinical treatment.

European journal of radiology. 2024 Mar 07 [Epub ahead of print]

Fuxiang Fang, Linfeng Wu, Xing Luo, Huiping Bu, Yueting Huang, Yong Xian Wu, Zheng Lu, Tianyu Li, Guanglin Yang, Yutong Zhao, Hongchao Weng, Jiawen Zhao, Chenjun Ma, Chengyang Li

Department of Urology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China. Electronic address: ., Department of Urology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China. Electronic address: ., Department of Urology, Baise People's Hospital, Baise 533099, China. Electronic address: ., Department of Radiology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China. Electronic address: ., Department of Epidemiology and Health Statistics, School of Public Health of Guangxi Medical University, Nanning 530021, China. Electronic address: ., Department of Urology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China. Electronic address: ., Department of Urology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China. Electronic address: ., Department of Urology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China. Electronic address: ., Department of Urology, Affiliated Cancer Hospital of Guangxi Medical University, Nanning 530021, China. Electronic address: ., Department of Urology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China. Electronic address: ., Department of Urology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China. Electronic address: ., Department of Urology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China. Electronic address: ., Department of Urology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China. Electronic address: ., Department of Urology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China. Electronic address: .