Interpretable machine learning and radiomics in hip MRI diagnostics: comparing ONFH and OA predictions to experts

Purpose Distinguishing between Osteonecrosis of the femoral head (ONFH) and Osteoarthritis (OA) can be subjective and vary between users with different backgrounds and expertise. This study aimed to construct and evaluate several Radiomics-based machine learning models using MRI to differentiate between those two disorders and compare their efficacies to those of medical experts.Methods 140 MRI scans were retrospectively collected from the electronic medical records. They were split into training and testing sets in a 7:3 ratio. Handcrafted radiomics features were harvested following the careful manual segmentation of the regions of interest (ROI). After thoroughly selecting these features, various machine learning models have been constructed. The evaluation was carried out using receiver operating characteristic (ROC) curves. Then NaiveBayes (NB) was selected to establish our final Radiomics-model as it performed the best. Three users with different expertise and backgrounds diagnosed and labeled the dataset into either OA or ONFH. Their results have been compared to our Radiomics-model.Results The amount of handcrafted radiomics features was 1197 before processing; after the final selection, only 12 key features were retained and used. User 1 had an AUC of 0.632 (95% CI 0.4801-0.7843), User 2 recorded an AUC of 0.565 (95% CI 0.4102-0.7196); while User 3 was on top with an AUC of 0.880 (95% CI 0.7753-0.9843). On the other hand, the Radiomics model attained an AUC of 0.971 (95% CI 0.9298-1.0000); showing greater efficacy than all other users. It also demonstrated a sensitivity of 0.937 and a specificity of 0.885. DCA (Decision Curve Analysis displayed that the radiomics-model had a greater clinical benefit in differentiating OA and ONFH.Conclusion We have successfully constructed and evaluated an interpretable radiomics-based machine learning model that could distinguish between OA and ONFH. This method has the ability to aid both junior and senior medical professionals to precisely diagnose and take prompt treatment measures.