Development and Validation of Predictive Models for Differentiating Resectable Stage III Peripheral SCLC from NSCLC Using Radiomic Features and Clinical Parameters

Objective Lung cancer is primarily categorized into small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC), each characterized by distinct therapeutic approaches and prognostic outcomes, particularly in stage III peripheral cases. This study aimed to develop predictive models utilizing...

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Main Authors: Junjie Zhang MD, Ligang Hao MD, Qiuxu Zhang MD, Lina Zheng MD, Qian Xu PhD, Fengxiao Gao MD
Format: Article
Language:English
Published: SAGE Publishing 2025-08-01
Series:Technology in Cancer Research & Treatment
Online Access:https://doi.org/10.1177/15330338251368956
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author Junjie Zhang MD
Ligang Hao MD
Qiuxu Zhang MD
Lina Zheng MD
Qian Xu PhD
Fengxiao Gao MD
author_facet Junjie Zhang MD
Ligang Hao MD
Qiuxu Zhang MD
Lina Zheng MD
Qian Xu PhD
Fengxiao Gao MD
author_sort Junjie Zhang MD
collection DOAJ
description Objective Lung cancer is primarily categorized into small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC), each characterized by distinct therapeutic approaches and prognostic outcomes, particularly in stage III peripheral cases. This study aimed to develop predictive models utilizing clinical and radiomic data to preoperatively differentiate stage III peripheral SCLC from NSCLC. Method We conducted a retrospective analysis of 33 stage III peripheral SCLC cases and 99 stage III peripheral NSCLC cases treated at our hospital between January 2016 and July 2024. A total of 1037 radiomic features were extracted from contrast-enhanced CT scans. The cohort was divided into a training set (n = 92) and a test set (n = 40). Radiomic feature selection was performed using the LASSO algorithm, and nine machine learning models were evaluated. The optimal model was employed to compute the radiomics score (Rad-score) and construct a clinical model. A combined model, integrating clinical factors and radiomic features, was assessed for clinical utility through receiver operating characteristic (ROC) curve analysis (area under the curve, AUC), KS statistics and decision curve analysis (DCA). We externally validated the combined model in a group of 84 patients from another hospital. Results The logistic regression-based combined model exhibited superior performance, achieving AUC values of 0.956, 0.775, and 0.841 for the combined, clinical, and radiomics models, respectively, within the training cohort, and 0.905, 0.864, and 0.732 in the test cohort. AUC for the combined model was 0.843 in the external validation cohort. The KS statistics and DCA indicated the clinical utility of the combined model, as evidenced by a Brier score of 0.115. Conclusion The integration of clinical parameters and radiomics features within the combined model may hold significant potential for the preoperative differentiation of stage III peripheral SCLC from NSCLC.
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spelling doaj-art-0748e6b0a4d547da9c48a2a5076a51b42025-08-22T09:04:08ZengSAGE PublishingTechnology in Cancer Research & Treatment1533-03382025-08-012410.1177/15330338251368956Development and Validation of Predictive Models for Differentiating Resectable Stage III Peripheral SCLC from NSCLC Using Radiomic Features and Clinical ParametersJunjie Zhang MD0Ligang Hao MD1Qiuxu Zhang MD2Lina Zheng MD3Qian Xu PhD4Fengxiao Gao MD5 Department of Computed Tomography and Magnetic Resonance, Xing Tai People's Hospital, Xing Tai, He Bei, China Department of Thoracic Surgery, Xing Tai People's Hospital, Xing Tai, He Bei, China Department of Laboratory Medicine, QingHe Hospital of Traditional Chinese Medicine, QingHe, XingTai, Hebei, China Department of Computed Tomography and Magnetic Resonance, Xing Tai People's Hospital, Xing Tai, He Bei, China Department of Computed Tomography and Magnetic Resonance, , Shijiazhuang, China Department of Computed Tomography and Magnetic Resonance, Xing Tai People's Hospital, Xing Tai, He Bei, ChinaObjective Lung cancer is primarily categorized into small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC), each characterized by distinct therapeutic approaches and prognostic outcomes, particularly in stage III peripheral cases. This study aimed to develop predictive models utilizing clinical and radiomic data to preoperatively differentiate stage III peripheral SCLC from NSCLC. Method We conducted a retrospective analysis of 33 stage III peripheral SCLC cases and 99 stage III peripheral NSCLC cases treated at our hospital between January 2016 and July 2024. A total of 1037 radiomic features were extracted from contrast-enhanced CT scans. The cohort was divided into a training set (n = 92) and a test set (n = 40). Radiomic feature selection was performed using the LASSO algorithm, and nine machine learning models were evaluated. The optimal model was employed to compute the radiomics score (Rad-score) and construct a clinical model. A combined model, integrating clinical factors and radiomic features, was assessed for clinical utility through receiver operating characteristic (ROC) curve analysis (area under the curve, AUC), KS statistics and decision curve analysis (DCA). We externally validated the combined model in a group of 84 patients from another hospital. Results The logistic regression-based combined model exhibited superior performance, achieving AUC values of 0.956, 0.775, and 0.841 for the combined, clinical, and radiomics models, respectively, within the training cohort, and 0.905, 0.864, and 0.732 in the test cohort. AUC for the combined model was 0.843 in the external validation cohort. The KS statistics and DCA indicated the clinical utility of the combined model, as evidenced by a Brier score of 0.115. Conclusion The integration of clinical parameters and radiomics features within the combined model may hold significant potential for the preoperative differentiation of stage III peripheral SCLC from NSCLC.https://doi.org/10.1177/15330338251368956
spellingShingle Junjie Zhang MD
Ligang Hao MD
Qiuxu Zhang MD
Lina Zheng MD
Qian Xu PhD
Fengxiao Gao MD
Development and Validation of Predictive Models for Differentiating Resectable Stage III Peripheral SCLC from NSCLC Using Radiomic Features and Clinical Parameters
Technology in Cancer Research & Treatment
title Development and Validation of Predictive Models for Differentiating Resectable Stage III Peripheral SCLC from NSCLC Using Radiomic Features and Clinical Parameters
title_full Development and Validation of Predictive Models for Differentiating Resectable Stage III Peripheral SCLC from NSCLC Using Radiomic Features and Clinical Parameters
title_fullStr Development and Validation of Predictive Models for Differentiating Resectable Stage III Peripheral SCLC from NSCLC Using Radiomic Features and Clinical Parameters
title_full_unstemmed Development and Validation of Predictive Models for Differentiating Resectable Stage III Peripheral SCLC from NSCLC Using Radiomic Features and Clinical Parameters
title_short Development and Validation of Predictive Models for Differentiating Resectable Stage III Peripheral SCLC from NSCLC Using Radiomic Features and Clinical Parameters
title_sort development and validation of predictive models for differentiating resectable stage iii peripheral sclc from nsclc using radiomic features and clinical parameters
url https://doi.org/10.1177/15330338251368956
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