%0 Journal Article
%T Differentiation of testicular seminomas from nonseminomas based on multiphase CT radiomics combined with machine learning: A multicenter study.
%A Fang F
%A Wu L
%A Luo X
%A Bu H
%A Huang Y
%A Xian Wu Y
%A Lu Z
%A Li T
%A Yang G
%A Zhao Y
%A Weng H
%A Zhao J
%A Ma C
%A Li C
%J Eur J Radiol
%V 175
%N 0
%D 2024 Jun 7
%M 38460443
%F 4.531
%R 10.1016/j.ejrad.2024.111416
%X <B>BACKGROUND: </B>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.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>The clinical-radiomics model serves as a potential tool for noninvasive differentiation between testicular seminomas and nonseminomas, offering valuable guidance for clinical treatment.