Feasibility of ultrasound radiomics based models for classification of liver fibrosis due to Schistosoma japonicum infection

Background: Schistosomiasis japonica represents a significant public health concern in South Asia. There is an urgent need to optimize existing schistosomiasis diagnostic techniques. This study aims to develop models for the different stages of liver fibrosis caused by Schistosoma infection utilizing ultrasound radiomics and machine learning techniques. Methods: From 2018 to 2022, we retrospectively collected data on 1,531 patients and 5,671 B-mode ultrasound images from the Second People’s Hospital of Duchang City, Jiangxi Province, China. The datasets were screened based on inclusion and exclusion criteria suitable for radiomics models. Liver fibrosis due to Schistosoma infection (LFSI) was categorized into four stages: grade 0, grade 1, grade 2, and grade 3. The data were divided into six binary classification problems, such as group 1 (grade 0 vs. grade 1) and group 2 (grade 0 vs. grade 2). Key radiomic features were extracted using Pyradiomics, the Mann-Whitney U test, and the Least Absolute Shrinkage and Selection Operator (LASSO). Machine learning models were constructed using Support Vector Machine (SVM), and the contribution of different features in the model was described by applying Shapley Additive Explanations (SHAP). Results: This study ultimately included 1,388 patients and their corresponding images. A total of 851 radiomics features were extracted for each binary classification problems. Following feature selection, 18 to 76 features were retained from each groups. The area under the receiver operating characteristic curve (AUC) for the validation cohorts was 0.834 (95% CI: 0.779–0.885) for the LFSI grade 0 vs. LFSI grade 1, 0.771 (95% CI: 0.713–0.835) for LFSI grade 1 vs. LFSI grade 2, and 0.830 (95% CI: 0.762–0.885) for LFSI grade 2 vs. LFSI grade 3. Conclusion: Machine learning models based on ultrasound radiomics are feasible for classifying different stages of liver fibrosis caused by Schistosoma infection. Author summary: Schistosomiasis is a devastating disease caused by parasitic worms, leading to stunting, reduced learning ability in children, and impaired work capacity in adults. Currently, there is no ideal staging system to assess schistosomiasis-related liver conditions. Advances in machine learning can help us understand and evaluate liver ultrasound images in entirely new dimensions. Regions with high infection rates are predominantly underdeveloped and characterized by a scarcity of medical resources, where B-mode ultrasound equipment serves as one of the primary diagnostic tools. This study aims to develop an intelligent recognition model based on ultrasound radiomics and machine learning to provide a basis for the ultrasound diagnosis of schistosomiasis.