Machine Learning Model Integrating Computed Tomography Image–Derived Radiomics and Circulating miRNAs to Predict Residual Teratoma in Metastatic Nonseminoma Testicular Cancer
Bibliographic record
Abstract
PURPOSE Chemotherapy is the primary treatment for metastatic nonseminomatous germ cell tumors (mNSGCTs), but patients often encounter postchemotherapy residual disease. Accurate noninvasive methods are needed to predict the histology of these masses, guiding treatment and reserving surgery for those with teratoma. This study aims to enhance predictive accuracy by integrating computed tomography (CT) radiomics features with miRNAs (miR371-375) to distinguish between teratoma and nonteratoma histology in postchemotherapy residual masses. METHODS We retrospectively identified 111 lesions, divided into training and test sets (n = 78 v 33) with equal class distribution. 3D Slicer was used to segment lesions with a short axis of >10 mm from the postchemo-presurgical CT images, and radiomics features were extracted. Presurgery plasma miR371-375 levels were measured by real-time polymerase chain reaction. Four machine learning models evaluated the predictive value of radiomics alone (R-only) and combined with miR371-375 levels, and the best performer was selected. Clinical factors associated with teratoma from univariate analysis were included in multivariate analysis with the best radiomics signature to assess their impact on predicting teratoma histology. RESULTS The CatBoost (CB) model R + 371 + 375 exhibited the best and most robust overall accuracy for predicting residual teratoma, with the highest AUC values (0.96, 95% CI, 0.88 to 1.0 for training, 0.83, 95% CI, 0.68 to 0.98 for testing) and a well-balanced sensitivity and specificity. Univariate analysis identified presurgery alpha-fetoprotein ( P = .01), beta-human chorionic gonadotropin ( P = .01), initial teratoma pathology ( P = .01), and lymph node metastases ( P = .02) as significant predictors for teratoma. Multivariate analysis included these features and the radiomics signature, which was the strongest independent predictor ( P < .0001). CONCLUSION Combining miR371-375 with CT radiomics features improves the accuracy of predicting teratoma histology of postchemotherapy residual disease in mNSGCTs and, therefore, has the potential to guide treatment decision making.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".