• Qianbiao Gu, Zhichao Feng, Qi Liang, Meijiao Li, Jiao Deng, Mengtian Ma, Wei Wang, Jianbin Liu, Peng Liu, and Pengfei Rong.
• Department of Radiology, The Third Xiangya Hospital of Central South University, Changsha 410013, China; Department of Radiology, The People's Hospital of Hunan Province, The First Hospital Affiliated of Hunan Normal University, Changsha 410005, China.
• Eur J Radiol. 2019 Sep 1; 118: 32-37.

PurposeTo explore the feasibility and performance of machine learning-based radiomics classifier to predict the cell proliferation(Ki-67)in non-small cell lung cancer (NSCLC).Methods245 histopathological confirmed NSCLC patients who underwent CT scans were retrospectively included. The Ki-67 proliferation index (Ki-67 PI) were measured within 2 weeks after CT scans. A lesion volume of interest (VOI) was manually delineated and radiomics features were extracted by MaZda software from CT images. A random forest feature selection algorithm (RFFS) was used to reduce features. Six kinds of machine learning methods were used to establish radiomics classifiers, subjective imaging feature classifiers and combined classifiers, respectively. The performance of these classifiers was evaluated by the receiver operating characteristic curve (ROC) and compared with Delong test.Results103 radiomics features were extracted and 20 optimal features were selected using RFFS. Among the radiomics classifiers established by six machine learning methods, random forest-based radiomics classifier achieved the best performance (AUC = 0.776) in predicting the Ki-67 expression level with sensitivity and specificity of 0.726 and 0.661, which was better than that of subjective imaging classifiers (AUC = 0.625, P < 0.05). However, the combined classifiers did not improve the predictive performance (AUC = 0.780, P > 0.05), with sensitivity and specificity of 0.752 and 0.633.ConclusionsThe machine learning-based CT radiomics classifier in NSCLC can facilitate the prediction of the expression level of Ki-67 and provide a novel non-invasive strategy for assessing the cell proliferation.Copyright © 2019 Elsevier B.V. All rights reserved.

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