Computed tomography-based radiomics machine learning models for prediction of histological invasiveness with sub-centimeter subsolid pulmonary nodules: a retrospective study

To improve the accuracy of preoperative diagnoses and avoid over- or undertreatment, we aimed to develop and compare computed tomography-based radiomics machine learning models for the prediction of histological invasiveness using sub-centimeter subsolid pulmonary nodules. Three predictive models based on radiomics were built using three machine learning classifiers to discriminate the invasiveness of the sub-centimeter subsolid pulmonary nodules. A total of 203 sub-centimeter nodules from 177 patients were collected and assigned randomly to the training set (n = 143) or test set (n = 60). The areas under the curve of the predictive models were 0.743 (95% confidence interval CI [0.661–0.824]) for the logistic regression, 0.828 (95% CI [0.76–0.896]) for the support vector machine, and 0.917 (95% CI [0.869–0.965]) for the XGBoost classifier models in the training set, and 0.803 (95% CI [0.694–0.913]), 0.726 (95% CI [0.598–0.854]), and 0.874 (95% CI [0.776–0.972]) in the test set, respectively. In addition, the decision curve showed that the XGBoost model added more net benefit within the range of 0.06 to 0.93.