Abstract
OBJECTIVE: Pituitary adenomas (PAs), craniopharyngiomas (CRs), Rathke's cleft cysts (RCCs), and tuberculum sellar meningiomas (TSMs) are common sellar region lesions with similar imaging characteristics, making differential diagnosis challenging. This study aims to develop and evaluate machine learning models using MRI-based radiomics features to differentiate these lesions. METHODS: Two hundred and fifty-eight pathologically diagnosed sellar region lesions, including 54 TSMs, 81 CRs, 61 RCCs and 63 PAs, were retrospectively studied. All patients underwent conventional MR examinations. Feature extraction and data normalization and balance were performed. Extreme gradient boosting (XGBoost), support vector machine (SVM), and logistic regression (LR) models were trained with the radiomics features. Five-fold cross-validation was used to evaluate model performance. RESULTS: The XGBoost model showed better performance than the SVM and LR models built from contrast-enhanced T1-weighted MRI features (balanced accuracy 0.83, 0.77, 0.75; AUC 0.956, 0.938, 0.929, respectively). Additionally, these models demonstrated significant differences in sensitivity (P = 0.032) and specificity (P = 0.045). The performance of the XGBoost model was superior to that of the SVM and LR models in differentiating sellar region lesions by using contrast-enhanced T1-weighted MRI features. CONCLUSION: The proposed model has the potential to improve the diagnostic accuracy in differentiating sellar region lesions.