Noninvasive prediction of failure of the conservative treatment in lateral epicondylitis by clinicoradiological features and elbow MRI radiomics based on interpretable machine learning: a multicenter cohort study
Abstract Objectives To develop and validate an interpretable machine learning model based on clinicoradiological features and radiomic features based on magnetic resonance imaging (MRI) to predict the failure of conservative treatment in lateral epicondylitis (LE). Methods This retrospective study i...
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BMC
2025-05-01
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| Series: | Journal of Orthopaedic Surgery and Research |
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| Online Access: | https://doi.org/10.1186/s13018-025-05901-1 |
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| author | Jianing Cui Ping Wang Xiaodong Zhang Ping Zhang Yuming Yin Rongjie Bai |
| author_facet | Jianing Cui Ping Wang Xiaodong Zhang Ping Zhang Yuming Yin Rongjie Bai |
| author_sort | Jianing Cui |
| collection | DOAJ |
| description | Abstract Objectives To develop and validate an interpretable machine learning model based on clinicoradiological features and radiomic features based on magnetic resonance imaging (MRI) to predict the failure of conservative treatment in lateral epicondylitis (LE). Methods This retrospective study included 420 patients with LE from three hospitals, divided into a training cohort (n = 245), an internal validation cohort (n = 115), and an external validation cohort (n = 60). Patients were categorized into conservative treatment failure (n = 133) and conservative treatment success (n = 287) groups based on the outcome of conservative treatment. We developed two predictive models: one utilizing clinicoradiological features, and another integrating clinicoradiological and radiomic features. Seven machine learning algorithms were evaluated to determine the optimal model for predicting the failure of conservative treatment. Model performance was assessed using ROC, and model interpretability was examined using SHapley Additive exPlanations (SHAP). Results The LightGBM algorithm was selected as the optimal model because of its superior performance. The combined model demonstrated enhanced predictive accuracy with an area under the ROC curve (AUC) of 0.96 (95% CI: 0.91, 0.99) in the external validation cohort. SHAP analysis identified the radiological feature “CET coronal tear size” and the radiomic feature “AX_log-sigma-1-0-mm-3D_glszm_SmallAreaEmphasis” as key predictors of conservative treatment failure. Conclusions We developed and validated an interpretable LightGBM machine learning model that integrates clinicoradiological and radiomic features to predict the failure of conservative treatment in LE. The model demonstrates high predictive accuracy and offers valuable insights into key prognostic factors. |
| format | Article |
| id | doaj-art-a3595fa4f44c443681f8d8c1f51b09d8 |
| institution | DOAJ |
| issn | 1749-799X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
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| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj-art-a3595fa4f44c443681f8d8c1f51b09d82025-08-20T03:08:43ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-05-0120111210.1186/s13018-025-05901-1Noninvasive prediction of failure of the conservative treatment in lateral epicondylitis by clinicoradiological features and elbow MRI radiomics based on interpretable machine learning: a multicenter cohort studyJianing Cui0Ping Wang1Xiaodong Zhang2Ping Zhang3Yuming Yin4Rongjie Bai5Department of Radiology, Beijing Jishuitan Hospital, Capital Medical UniversityDepartment of Radiology, Beijing Jishuitan Hospital, Capital Medical UniversityDepartment of Radiology, The Third Affiliated Hospital, Southern Medical UniversityDepartment of Radiology, Beijing Geriatric HospitalDepartment of Radiology, Pomona Valley Hospital Medical CenterDepartment of Radiology, Beijing Jishuitan Hospital, Capital Medical UniversityAbstract Objectives To develop and validate an interpretable machine learning model based on clinicoradiological features and radiomic features based on magnetic resonance imaging (MRI) to predict the failure of conservative treatment in lateral epicondylitis (LE). Methods This retrospective study included 420 patients with LE from three hospitals, divided into a training cohort (n = 245), an internal validation cohort (n = 115), and an external validation cohort (n = 60). Patients were categorized into conservative treatment failure (n = 133) and conservative treatment success (n = 287) groups based on the outcome of conservative treatment. We developed two predictive models: one utilizing clinicoradiological features, and another integrating clinicoradiological and radiomic features. Seven machine learning algorithms were evaluated to determine the optimal model for predicting the failure of conservative treatment. Model performance was assessed using ROC, and model interpretability was examined using SHapley Additive exPlanations (SHAP). Results The LightGBM algorithm was selected as the optimal model because of its superior performance. The combined model demonstrated enhanced predictive accuracy with an area under the ROC curve (AUC) of 0.96 (95% CI: 0.91, 0.99) in the external validation cohort. SHAP analysis identified the radiological feature “CET coronal tear size” and the radiomic feature “AX_log-sigma-1-0-mm-3D_glszm_SmallAreaEmphasis” as key predictors of conservative treatment failure. Conclusions We developed and validated an interpretable LightGBM machine learning model that integrates clinicoradiological and radiomic features to predict the failure of conservative treatment in LE. The model demonstrates high predictive accuracy and offers valuable insights into key prognostic factors.https://doi.org/10.1186/s13018-025-05901-1Lateral epicondylitisMachine learningMagnetic resonance imagingRadiomicsSHapley additive explanation |
| spellingShingle | Jianing Cui Ping Wang Xiaodong Zhang Ping Zhang Yuming Yin Rongjie Bai Noninvasive prediction of failure of the conservative treatment in lateral epicondylitis by clinicoradiological features and elbow MRI radiomics based on interpretable machine learning: a multicenter cohort study Journal of Orthopaedic Surgery and Research Lateral epicondylitis Machine learning Magnetic resonance imaging Radiomics SHapley additive explanation |
| title | Noninvasive prediction of failure of the conservative treatment in lateral epicondylitis by clinicoradiological features and elbow MRI radiomics based on interpretable machine learning: a multicenter cohort study |
| title_full | Noninvasive prediction of failure of the conservative treatment in lateral epicondylitis by clinicoradiological features and elbow MRI radiomics based on interpretable machine learning: a multicenter cohort study |
| title_fullStr | Noninvasive prediction of failure of the conservative treatment in lateral epicondylitis by clinicoradiological features and elbow MRI radiomics based on interpretable machine learning: a multicenter cohort study |
| title_full_unstemmed | Noninvasive prediction of failure of the conservative treatment in lateral epicondylitis by clinicoradiological features and elbow MRI radiomics based on interpretable machine learning: a multicenter cohort study |
| title_short | Noninvasive prediction of failure of the conservative treatment in lateral epicondylitis by clinicoradiological features and elbow MRI radiomics based on interpretable machine learning: a multicenter cohort study |
| title_sort | noninvasive prediction of failure of the conservative treatment in lateral epicondylitis by clinicoradiological features and elbow mri radiomics based on interpretable machine learning a multicenter cohort study |
| topic | Lateral epicondylitis Machine learning Magnetic resonance imaging Radiomics SHapley additive explanation |
| url | https://doi.org/10.1186/s13018-025-05901-1 |
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