Fusion-based tensor radiomics using reproducible features: Application to survival prediction in head and neck cancer

Numerous features are commonly generated in radiomics applications as applied to medical imaging, and identification of robust radiomics features (RFs) can be an important step to derivation of reliable, reproducible solutions. In this work, we utilize a tensor radiomics (TR) framework, where numerous fusions are explored, to generate different flavours of RFs, and we aimed to identify RFs that are robust to fusion techniques in head and neck cancer. Overall, we aimed to predict progression-free survival (PFS) using Hybrid Machine Learning Systems (HMLS) and reproducible RFs. The study was performed on 408 patients with head and neck cancer from The Cancer Imaging Archive. After image preprocessing, 15 fusion techniques were employed to combine Positron Emission Tomography (PET) and Computed Tomography (CT) images. Subsequently, 215 RFs were extracted through a standardized radiomics software, with 17 ‘flavours’ generated using PET-only, CT-only, and 15 fused PET&CT images. The variability of RFs across flavours was studied using the Intraclass Correlation Coefficient (ICC). Furthermore, the features were categorized into seven reliability groups, 106 reproducible RFs with ICC>0.75 were selected, highly correlated flavours were removed, Principal Component Analysis was used to convert 17 flavours to 1 attribute, the polynomial function was utilized to increase RFs, and Analysis of variance (ANOVA) was used to select the relevant attributes. Finally, 3 classifiers including Random Forest (RFC), Logistic regression (LR), and Multi-layer perceptron were applied to the preselected relevant attributes to predict binary PFS. In 5-fold cross-validation, 80% of 4 divisions were utilized to train the model, and the remaining 20% was utilized to evaluate the model. Further, the remaining fold was used for external nested testing. Reliability analysis indicated that most morphological features belong to the high-reliability category. By contrast, local intensity and statistical features extracted from images belong to the low-reliability category. In the tensor framework, the highest 5-fold cross-validation accuracy of 76.7%±3.3% with an external nested testing of 70.6%±6.7% resulted from the reproducible TR+polynomial function+ANOVA+LR algorithm while the accuracy of 70.0%±4.2% with the external nested testing of 67.7%±4.9% was achieved through the PCA fusion+RFC (non-tensor paradigm). This study demonstrated that using reproducible RFs as utilized within a tensor fusion radiomics framework, linked with ANOVA and LR, added value to prediction of progression-free survival outcome in head and neck cancer patients.