Preoperative classification of primary and metastatic liver cancer via machine learning-based ultrasound radiomics.

To investigate the application of machine learning–based ultrasound radiomics in preoperative classification of primary and metastatic liver cancer. Data of 114 consecutive histopathologically confirmed patients with liver cancer from January 2018 to November 2019 were retrospectively analyzed. All patients underwent liver ultrasonography within 1 week before hepatectomy or fine-needle biopsy. The liver lesions were manually segmented by two experts using ITK-SNAP software. Seven categories of radiomics features, including first-order, two-dimensional shape, gray-level co-occurrence matrices, gray-level run-length matrix, gray-level size-zone matrix, neighboring gray tone difference matrix, and gray-level dependence matrix, were extracted on the Pyradiomics platform. Fourteen filters were applied to the original images, and derived images were obtained. Then, the dimensions of radiomics features were reduced by least absolute shrinkage and selection operator (Lasso) method. Finally, k-nearest neighbor (KNN), logistic regression (LR), multilayer perceptron (MLP), random forest (RF), and support vector machine (SVM) were employed to distinguish primary liver cancer from metastatic liver cancer by a fivefold cross-validation strategy. The performance of the established model was mainly evaluated by the area under the receiver operating characteristic (ROC) curve (AUC) and accuracy. One thousand four hundred nine radiomics features were extracted from the original images and/or derived images for each patient. The mentioned five machine learning classifiers were able to differentiate primary liver cancer from metastatic liver cancer. LR outperformed other classifiers, with the accuracy of 0.843 ± 0.078 (AUC, 0.816 ± 0.088; sensitivity, 0.768 ± 0.232; specificity, 0.880 ± 0.117). Machine learning–based ultrasound radiomics features are able to non-invasively distinguish primary liver tumors from metastatic liver tumors. • Ultrasound-based radiomics was initially used for preoperative classification of primary versus metastatic liver cancer. • Multiple machine learning–based algorithms with cross-validation strategy were applied to extract machine learning–based ultrasound radiomics features. • Distinction between primary and metastatic tumors was obtained with a sensitivity of 0.768 and a specificity of 0.880.