{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:15:04Z","timestamp":1783383304124,"version":"3.54.6"},"reference-count":42,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,7,8]],"date-time":"2024-07-08T00:00:00Z","timestamp":1720396800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Predicting the accurate preoperative staging of bladder cancer (BLCA), which markedly affects treatment decisions and patient outcomes, using traditional clinical parameters is challenging. Nevertheless, emerging studies in radiomics, especially machine learning\u2010based computed tomography (CT) image\u2010based radiomics, hold promise in improving stage prediction accuracy in various tumors. However, the comparative performance and clinical utility of models for BLCA are under investigation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>We aimed to investigate the application value of machine learning\u2010based CT radiomics in preoperative staging prediction by comparing the performance of clinical, radiomics, and clinical\u2013radiomics combined models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort of 105 patients with initial BLCA was randomized into training (70%) and testing (30%) cohorts. Radiomics features were extracted from CT images using the optimal feature filter, followed by the application of the least absolute shrinkage and selection operator algorithm for optimum feature selection. Furthermore, machine learning algorithms were used to establish a radiomics model within the training cohort. Independent risk factors for muscle\u2010invasive BLCA (MIBC) obtained by multivariate logistic regression (LR) analysis were separately used to construct a clinical model. For a clinical\u2013radiomics fusion model, radiomics features were combined with clinical parameters. Performance was evaluated based on receiver operating characteristic curves, calibration curves, decision curve analysis (DCA), and standard performance metrics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients exhibited a significantly higher age (<jats:italic>p\u00a0<\/jats:italic>=\u00a00.029), larger tumor size (<jats:italic>p\u00a0<\/jats:italic>=\u00a00.01), and an increased neutrophil\u2010to\u2010lymphocyte ratio (NLR; <jats:italic>p\u00a0<\/jats:italic>=\u00a00.045) in the MIBC group than in the NMIBC group. LR analysis revealed age (<jats:italic>p\u00a0<\/jats:italic>=\u00a00.026), tumor size (<jats:italic>p\u00a0<\/jats:italic>=\u00a00.007), and NLR (<jats:italic>p\u00a0<\/jats:italic>=\u00a00.019) as significant predictors for constructing the clinical model. In the testing cohort, the radiomics model, which used an Support Vector Machine classifier, achieved the highest area under the curve (AUC) value of 0.857. The clinical\u2013radiomics model outperformed the remaining two models, with AUC values of 0.958 and 0.893 in the training and testing cohorts, respectively. DeLong's test indicated significant differences between the three models. Calibration curves showed good agreement, and DCA confirmed the superior clinical utility of the clinical\u2013radiomics model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Machine learning\u2010based CT radiomics combined with clinical parameters was a promising approach in staging BLCA accurately, which outperformed the individual models. Integrating radiomics features with clinical information holds the potential to improve personalized treatment planning and patient outcomes in BLCA.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.17288","type":"journal-article","created":{"date-parts":[[2024,7,8]],"date-time":"2024-07-08T20:19:12Z","timestamp":1720469952000},"page":"5965-5977","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Machine learning\u2010based CT radiomics enhances bladder cancer staging predictions: A comparative study of clinical, radiomics, and combined models"],"prefix":"10.1002","volume":"51","author":[{"given":"Situ","family":"Xiong","sequence":"first","affiliation":[{"name":"Department of Urology The First Affiliated Hospital Jiangxi Medical College Nanchang University  Nanchang Jiangxi China"},{"name":"Jiangxi Provincial Key Laboratory of Urinary System Diseases  Nanchang 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