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The purpose of this study was to assess radiomics versus dual-energy CT (DECT) material decomposition to objectively distinguish visually unequivocal abdominal lymphoma and benign lymph nodes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Retrospectively, 72 patients [<jats:italic>m<\/jats:italic>, 47; age, 63.5 (27\u201387) years] with nodal lymphoma (<jats:italic>n<\/jats:italic>\u2009=\u200927) or benign abdominal lymph nodes (<jats:italic>n<\/jats:italic>\u2009=\u200945) who had contrast-enhanced abdominal DECT between 06\/2015 and 07\/2019 were included. Three lymph nodes per patient were manually segmented to extract radiomics features and DECT material decomposition values. We used intra-class correlation analysis, Pearson correlation and LASSO to stratify a robust and non-redundant feature subset. Independent train and test data were applied on a pool of four machine learning models. Performance and permutation-based feature importance was assessed to increase the interpretability and allow for comparison of the models. Top performing models were compared by the DeLong test.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>About 38% (19\/50) and 36% (8\/22) of the train and test set patients had abdominal lymphoma. Clearer entity clusters were seen in t-SNE plots using a combination of DECT and radiomics features compared to DECT features only. Top model performances of AUC\u2009=\u20090.763 (CI\u2009=\u20090.435\u20130.923) were achieved for the DECT cohort and AUC\u2009=\u20091.000 (CI\u2009=\u20091.000\u20131.000) for the radiomics feature cohort to stratify visually unequivocal lymphomatous lymph nodes. The performance of the radiomics model was significantly (<jats:italic>p<\/jats:italic>\u2009=\u20090.011, DeLong) superior to the DECT model.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Radiomics may have the potential to objectively stratify visually unequivocal nodal lymphoma versus benign lymph nodes. Radiomics seems superior to spectral DECT material decomposition in this use case. Therefore, artificial intelligence methodologies may not be restricted to centers with DECT equipment.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s11548-023-02854-w","type":"journal-article","created":{"date-parts":[[2023,3,6]],"date-time":"2023-03-06T10:05:04Z","timestamp":1678097104000},"page":"1829-1839","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Comparison of radiomics models and dual-energy material decomposition to decipher abdominal lymphoma in contrast-enhanced CT"],"prefix":"10.1007","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7758-8100","authenticated-orcid":false,"given":"Simon","family":"Bernatz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vitali","family":"Koch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Pinto","family":"Dos Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Ackermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leon D.","family":"Gr\u00fcnewald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inga","family":"Weitkamp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Yel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon S.","family":"Martin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Lenga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-Erik","family":"Scholtz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J.","family":"Vogl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scherwin","family":"Mahmoudi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,3,6]]},"reference":[{"key":"2854_CR1","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1148\/radiology.180.2.2068292","volume":"180","author":"RE Dorfman","year":"1991","unstructured":"Dorfman RE, Alpern MB, Gross BH, Sandler MA (1991) Upper abdominal lymph nodes: criteria for normal size determined with CT. 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Simon Bernatz: no relevant financial or non-financial interests to disclose; Vitali Koch: no relevant financial or non-financial interests to disclose; Daniel Pinto Dos Santos: no relevant financial or non-financial interests to disclose; J\u00f6rg Ackermann: no relevant financial or non-financial interests to disclose; Leon D. Gr\u00fcnewald: no relevant financial or non-financial interests to disclose; Inga Weitkamp: no relevant financial or non-financial interests to disclose; Ibrahim Yel: no relevant financial or non-financial interests to disclose; Simon S. Martin: no relevant financial or non-financial interests to disclose; Lukas Lenga: no relevant financial or non-financial interests to disclose; Jan-Erik Scholtz: no relevant financial or non-financial interests to disclose; Thomas J. Vogl: no relevant financial or non-financial interests to disclose and Scherwin Mahmoudi: no relevant financial or non-financial interests to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The local ethics committee approved this retrospective study (project number: 20\u2013688 Goethe University Frankfurt am Main, Germany) and waived informed written consent.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"The local ethics committee approved this retrospective study (project number: 20\u2013688 Goethe University Frankfurt am Main, Germany) and waived informed written consent.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}