关键词: 血吸虫病, 肝纤维化, 超声影像, 影像组学, 诊断模型

Abstract: Objective　To investigate the feasibility of developing a grading diagnostic model for schistosomiasis⁃induced liver fibrosis based on B⁃mode ultrasonographic images and clinical laboratory indicators. Methods　Ultrasound images and clinical laboratory testing data were captured from schistosomiasis patients admitted to the Second People’s Hospital of Duchang County, Jiangxi Province from 2018 to 2022. Patients with grade Ⅰ schistosomiasis⁃induced liver fibrosis were enrolled in Group 1, and patients with grade Ⅱ and Ⅲ schistosomiasis⁃induced liver fibrosis were enrolled in Group 2. The machine learning binary classification tasks were created based on patients’ radiomics and clinical laboratory data from 2018 to 2021 as the training set, and patients’ radiomics and clinical laboratory data in 2022 as the validation set. The features of ultrasonographic images were labeled with the ITK⁃SNAP software, and the features of ultrasonographic images were extracted using the Python 3.7 package and PyRadiomics toolkit. The difference in the features of ultrasonographic images was compared between groups with t test or Mann⁃Whitney U test, and the key imaging features were selected with the least absolute shrinkage and selection operator (LASSO) regression algorithm. Four machine learning models were created using the Scikit⁃learn repository, including the support vector machine (SVM), random forest (RF), linear regression (LR) and extreme gradient boosting (XGBoost). The optimal machine learning model was screened with the receiver operating characteristic curve (ROC), and features with the greatest contributions to the differentiation features of ultrasound images in machine learning models with the SHapley Additive exPlanations (SHAP) method. Results　The ultrasonographic imaging data and clinical laboratory testing data from 491 schistosomiasis patients from 2019 to 2022 were included in the study, and a total of 851 radiomics features and 54 clinical laboratory indicators were captured. Following statistical tests (t = -5.98 to 4.80, U = 6 550 to 20 994, all P values < 0.05) and screening of key features with LASSO regression, 44 features or indicators were included for the subsequent modeling. The areas under ROC curve (AUCs) were 0.763 and 0.611 for the training and validation sets of the SVM model based on clinical laboratory indicators, 0.951 and 0.892 for the training and validation sets of the SVM model based on radiomics, and 0.960 and 0.913 for the training and validation sets of the multimodal SVM model. The 10 greatest contributing features or indicators in machine learning models included 2 clinical laboratory indicators and 8 radiomics features. Conclusions　The multimodal machine learning models created based on ultrasound⁃based radiomics and clinical laboratory indicators are feasible for intelligent identification of schistosomiasis⁃induced liver fibrosis, and are effective to improve the classification effect of one⁃class data models. 　

Key words: Schistosomiasis, Liver fibrosis, Ultrasound imaging, Radiomics, Diagnostic model