Abstract
PROBLEM: Sinonasal squamous cell carcinoma (SNSCC) and sinonasal lymphoma (SNL) lack distinct clinical manifestations and traditional imaging characteristics, complicating the accurate differentiation between these tumors and the selection of appropriate treatment strategies. Consequently, there is an urgent need for a method that can precisely distinguish between these tumors preoperatively to formulate suitable treatment plans for patients. METHODS: This study aims to construct and validate ML and DL feature models based on Dynamic Contrast-Enhanced (DCE) imaging and to evaluate the clinical value of a radiomics and deep learning (DL) feature fusion model in differentiating between SNSCC and SNL. This study performed a retrospective analysis on the preoperative axial DCE-T1WI MRI images of 90 patients diagnosed with sinonasal tumors, comprising 50 cases of SNSCC and 40 cases of SNL. Data were randomly divided into a training set and a validation set at a 7:3 ratio, and radiomic features were extracted. Concurrently, deep learning features were derived using the optimally pre-trained DL model and integrated with manually extracted radiomic features. Feature sets were selected through independent samples t-test, Mann-Whitney U-test, Pearson correlation coefficient and LASSO regression. Three conventional machine learning (CML) models and three DL models were established, and all radiomic and DL features were merged to create three pre-fusion machine learning models (DLR). Additionally, a post-fusion model (DLRN) was constructed by combining radiomic scores and DL scores. Quantitative metrics such as area under the curve (AUC), sensitivity, and accuracy were employed to identify the optimal feature set and classifier. Furthermore, a deep learning-radiomics nomogram (DLRN) was developed as a clinical decision-support tool. RESULTS: The feature fusion model of radiomics and DL has higher accuracy in distinguishing SNSCC from SNL than CML or DL alone. The ExtraTrees model based on DLR fusion features of DCE-T1WI had an AUC value of 0.995 in the training set and 0.939 in the validation set.The DLRN model based on the fusion of predictive scores had an AUC value of 0.995 in the training set and 0.911 in the validation set.The DLRN model based on the fusion of predictive scores had an AUC value of 0.995 in the training set and 0.911 in the validation set. CONCLUSION: This study, by constructing a feature integration model combining radiomics and deep learning (DL), has demonstrated strong predictive capabilities in the preoperative non-invasive diagnosis of SNSCC and SNL, offering valuable information for tailoring personalized treatment plans for patients.