Application of Artificial Neural Networks for Prognostic Modeling in Lung Cancer after Combining Radiomic and Clinical Features

Abstract

Abstract Objective This study was aimed to investigate machine learning (ML) and artificial neural networks (ANNs) in the prognostic modeling of lung cancer, utilizing high-dimensional data. Materials and Methods A computed tomography (CT) dataset of inoperable nonsmall cell lung carcinoma (NSCLC) patients with embedded tumor segmentation and survival status, comprising 422 patients, was selected. Radiomic data extraction was performed on Computation Environment for Radiation Research (CERR). The survival probability was first determined based on clinical features only and then unsupervised ML methods. Supervised ANN modeling was performed by direct and hybrid modeling which were subsequently compared. Statistical significance was set at <0.05. Results Survival analyses based on clinical features alone were not significant, except for gender. ML clustering performed on unselected radiomic and clinical data demonstrated a significant difference in survival (two-step cluster, median overall survival [ mOS]: 30.3 vs. 17.2 m; p = 0.03; K-means cluster, mOS: 21.1 vs. 7.3 m; p < 0.001). Direct ANN modeling yielded a better overall model accuracy utilizing multilayer perceptron (MLP) than radial basis function (RBF; 79.2 vs. 61.4%, respectively). Hybrid modeling with MLP (after feature selection with ML) resulted in an overall model accuracy of 80%. There was no difference in model accuracy after direct and hybrid modeling (p = 0.164). Conclusion Our preliminary study supports the application of ANN in predicting outcomes based on radiomic and clinical data.