Machine learning-based radiomics using magnetic resonance images for prediction of clinical complete response to neoadjuvant chemotherapy in patients with muscle-invasive bladder cancer
Bibliographic record
Abstract
Abstract Purpose Predicting clinical complete response (CR) to neoadjuvant chemotherapy (NAC) in patients with muscle-invasive bladder cancer (MIBC) remains a clinical challenge. Existing CT-based radiomics studies have shown promise, but MRI-derived radiomics using machine learning (ML) has not been systematically explored. This study aimed to develop and validate ML-based radiomics models using multiparametric MRI and clinical data to predict CR in MIBC patients receiving NAC. Materials and methods MIBC patients eligible for platinum-based NAC were prospectively included. Tumor regions were manually segmented from pre-treatment MRI sequences (CE-T1WI, T2WI, DWI, ADC maps). Radiomics features and clinical variables were extracted. Least Absolute Shrinkage and Selection Operator (LASSO) was used for feature selection, and multiple ML classifiers were trained using stratified fivefold cross-validation. The area under the receiver operating characteristic curve (AUC-ROC), sensitivity, specificity, precision, and F1 scores were calculated. Results Among 52 patients, 19 (36.5%) achieved CR. Of 177 extracted features, CE-T1WI-derived models achieved the best performance. The support vector machine (SVM) yielded the highest AUC-ROC of 0.88, with sensitivity, specificity, and precision of 0.82, 0.79, and 0.79, respectively. The K-Nearest Neighbors (KNN) model performed comparably (AUC = 0.87). Clinical feature-based models also performed strongly (RF, AUC = 0.86). Conclusions ML-based radiomics models derived from multiparametric MRI sequences and clinical features hold substantial potential for predicting clinical CR to the NAC in MIBC patients. These results suggest that MR images can provide reliable insights into treatment response, offering a noninvasive and effective tool for clinical decision-making. This is the first prospective ML-based MRI radiomics study in this domain. We present this work as a proof-of-concept requiring external multicenter validation in a larger dataset to confirm these findings.
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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 | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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".