Abstract
BACKGROUND: Distinguishing between benign and malignant testicular lesions on clinical magnetic resonance imaging (MRI) is crucial for guiding treatment planning. However, conventional MRI-based radiomics to identify testicular cancer requires expert machine learning knowledge. This study aims to investigate the potential of utilizing automatic machine learning (AutoML) based on MRI to diagnose testicular lesions without the need for expert algorithm optimization. METHODS: Retrospective preoperative MRI scans from 115 patients diagnosed with testicular disease through pathology were obtained. A total of 1781 radiomics features were extracted from each lesion on the T2-weighted images. Intraclass and interclass correlation coefficients were used to evaluate the intra-observer and interobserver agreements for each radiomics feature. We developed an AutoML method based on the tree-based pipeline optimization tool (TPOT) algorithm to construct a discriminant model. The best pipeline was determined through 100 repeated operations using a 5-fold cross-validation algorithm in TPOT. The model was evaluated for accuracy, sensitivity, and specificity using the area under the curve (AUC) value of the receiver operating characteristic (ROC) curve. Shapley Additive exPlanations were used to illustrate the optimization results. RESULTS: Utilizing the TPOT method, 100 diagnostic models were developed to identify testicular lesions. The best model was determined based on the highest AUC in the training cohort. The prediction model yielded AUC values of 0.989 (95% confidence interval [CI]: 0.985-0.993) and 0.909 (95% CI: 0.893-0.923) in the training and testing cohorts, respectively. CONCLUSIONS: AutoML, based on the TPOT algorithm, holds potential as a noninvasive method for effectively discriminating between benign and malignant testicular lesions.