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Nodules were divided into training (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200961 non-IVA,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009165 IVA) and test sets (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200936 non-IVA,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009203 IVA). Two MLR models were developed with 18 significant factors for the NSR model and 19 significant factors for the HSR model from 172 radiomics features using random forest. Area under the receiver operator characteristic curves (AUC) was analyzed using DeLong\u2019s test in the test set. Accuracy (acc), sensitivity (sen), and specificity (spc) of R1 and R2 with and without model-HSR were compared using McNemar test.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      437 patients (70\u2009\u00b1\u20099\u00a0years, 203 men) had 465 nodules (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009368, IVA). Model-HSR AUCs were significantly higher than model-NSR in training (0.839 vs. 0.723) and test sets (0.863 vs. 0.718) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). R1\u2019s acc (87.2%) and sen (93.1%) with model-HSR were significantly higher than without (77.0% and 79.3%) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). R2\u2019s acc (83.7%) and sen (86.7%) with model-HSR might be equal or higher than without (83.7% and 85.7%, respectively), but not significant (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.50). Spc of R1 (52.8%) and R2 (66.7%) with model-HSR might be lower than without (63.9% and 72.2%, respectively), but not significant (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.21).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>HSR-based MLR model significantly increased IVA diagnostic performance compared to NSR, supporting radiologists without compromising accuracy and sensitivity. However, this benefit came at the cost of reduced specificity, potentially increasing false positives, which may lead to unnecessary examinations or overtreatment in clinical settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11604-025-01839-w","type":"journal-article","created":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T03:50:40Z","timestamp":1753933840000},"page":"2003-2017","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effect of spatial resolution on the diagnostic performance of machine-learning radiomics model in lung adenocarcinoma: comparisons between normal- and high-spatial-resolution imaging for predicting invasiveness"],"prefix":"10.1007","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0911-6769","authenticated-orcid":false,"given":"Masahiro","family":"Yanagawa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukihiro","family":"Nagatani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akinori","family":"Hata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromitsu","family":"Sumikawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Moriya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shingo","family":"Iwano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nanae","family":"Tsuchiya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae","family":"Iwasawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiharu","family":"Ohno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriyuki","family":"Tomiyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,31]]},"reference":[{"key":"1839_CR1","doi-asserted-by":"publisher","first-page":"12","DOI":"10.3322\/caac.21820","volume":"74","author":"RL Siegel","year":"2024","unstructured":"Siegel RL, Giaquinto AN, Jemal A. 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Yanagawa has received research support and payment for lectures from Canon Medical Systems Corporation. This study was also supported by a grant from the Grants-in-Aid for Scientific Research\u2013KAKENHI (JP21K07672). H.Moriya receives research grants and payment for lectures from Canon Medical Systems Corporation. T.Iwasawa receives research grants from Canon Medical Systems Corporation. and Ziosft Inc., and payment for lectures from Boehringer-ingelheim Japan and Canon Medical Systems Corporation. Y.Ohno receives research grants from Canon Medical Systems Corporation, LPIXEL Corporation and the Smoking Research Foundation. N. Tomiyama has received payment for lectures from Canon Medical Systems Corporation.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This retrospective multicenter study was approved by the institutional review board of each hospital (1. Osaka University Hospital: approval number, 19225; 2. Shiga University Hospital; approval number, R2019-288; 3. Ohara General Hospital: approval number, 195; 4. Kinki-Chuo Chest Medical Center, approval number, 2021-010; 5. University of the Ryukyus Hospital: approval number, 1559; 6. Nagoya University Hospital: approval number, 2020-0539; 7. Kanagawa Cardiovascular & Respiratory Center, approval number, KCRC-19-0040; and 8. Fujita Health University Hospital, approval number, HM20-362). The procedures used in this study adhere to the tenets of the Declaration of Helsinki.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was waived for review of the patients\u2019 records and images.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"This retrospective multicenter study was approved by the institutional review board of each hospital, and informed consent was waived for this retrospective study.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"This retrospective multicenter study was approved by the institutional review board of each hospital, and informed consent was waived for this retrospective study.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}