Non-Small Cell Lung Carcinoma Histopathological Subtype Phenotyping using High-Dimensional Multinomial Multiclass CT Radiomics Signature

Objective: The aim of this study was to identify the most important features and assess their discriminative power in the classification of the subtypes of NSCLC. Methods: This study involved 354 pathologically proven NSCLC patients including 134 squamous cell carcinoma (SCC), 110 large cell carcinoma (LCC), 62 not other specified (NOS), and 48 adenocarcinoma (ADC). In total, 1433 radiomics features were extracted from 3D volumes of interest drawn on the malignant lesion identified on CT images. Wrapper algorithm and multivariate adaptive regression splines were implemented to identify the most relevant/discriminative features. A multivariable multinomial logistic regression was employed with 1000 bootstrapping samples based on the selected features to classify four main subtypes of NSCLC. Results: The results revealed that the texture features, specifically gray level size zone matrix features (GLSZM), were the significant indicators of NSCLC subtypes. The optimized classifier achieved an average precision, recall, F1-score, and accuracy of 0.710, 0.703, 0.706, and 0.865, respectively, based on the selected features by the wrapper algorithm. Conclusions: Our CT radiomics approach demonstrated impressive potential for the classification of the four main histological subtypes of NSCLC, It is anticipated that CT radiomics could be useful in treatment planning and precision medicine