{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T11:10:14Z","timestamp":1791976214878,"version":"4.4.0"},"reference-count":47,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,5,26]],"date-time":"2023-05-26T00:00:00Z","timestamp":1685059200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"China Medical University Hospital","award":["DMR-112-072"],"award-info":[{"award-number":["DMR-112-072"]}]},{"name":"China Medical University Hospital","award":["DMR-112-073"],"award-info":[{"award-number":["DMR-112-073"]}]},{"name":"China Medical University Hospital","award":["DMR-109-066"],"award-info":[{"award-number":["DMR-109-066"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Lumbar degenerative disc disease (LDDD) is a leading cause of chronic lower back pain; however, a lack of clear diagnostic criteria and solid LDDD interventional therapies have made predicting the benefits of therapeutic strategies challenging. Our goal is to develop machine learning (ML)\u2013based radiomic models based on pre-treatment imaging for predicting the outcomes of lumbar nucleoplasty (LNP), which is one of the interventional therapies for LDDD. Methods: The input data included general patient characteristics, perioperative medical and surgical details, and pre-operative magnetic resonance imaging (MRI) results from 181 LDDD patients receiving lumbar nucleoplasty. Post-treatment pain improvements were categorized as clinically significant (defined as a \u226580% decrease in the visual analog scale) or non-significant. To develop the ML models, T2-weighted MRI images were subjected to radiomic feature extraction, which was combined with physiological clinical parameters. After data processing, we developed five ML models: support vector machine, light gradient boosting machine, extreme gradient boosting, extreme gradient boosting random forest, and improved random forest. Model performance was measured by evaluating indicators, such as the confusion matrix, accuracy, sensitivity, specificity, F1 score, and area under the receiver operating characteristic curve (AUC), which were acquired using an 8:2 allocation of training to testing sequences. Results: Among the five ML models, the improved random forest algorithm had the best performance, with an accuracy of 0.76, a sensitivity of 0.69, a specificity of 0.83, an F1 score of 0.73, and an AUC of 0.77. The most influential clinical features included in the ML models were pre-operative VAS and age. In contrast, the most influential radiomic features had the correlation coefficient and gray-scale co-occurrence matrix. Conclusions: We developed an ML-based model for predicting pain improvement after LNP for patients with LDDD. We hope this tool will provide both doctors and patients with better information for therapeutic planning and decision-making.<\/jats:p>","DOI":"10.3390\/diagnostics13111863","type":"journal-article","created":{"date-parts":[[2023,5,27]],"date-time":"2023-05-27T16:16:04Z","timestamp":1685204164000},"page":"1863","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Machine Learning Assisting the Prediction of Clinical Outcomes following Nucleoplasty for Lumbar Degenerative Disc Disease"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4123-1617","authenticated-orcid":false,"given":"Po-Fan","family":"Chiu","sequence":"first","affiliation":[{"name":"Spine Center, China Medical University Hospital, Taichung 404327, Taiwan"},{"name":"Department of Neurosurgery, China Medical University Hospital, Taichung 404327, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3233-8087","authenticated-orcid":false,"given":"Robert Chen-Hao","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering, National Chung Hsing University, Taichung 40227, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yung-Chi","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung 404327, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9292-2819","authenticated-orcid":false,"given":"Kuo-Chen","family":"Wu","sequence":"additional","affiliation":[{"name":"Center of Artificial Intelligence, China Medical University Hospital, Taichung 404327, Taiwan"},{"name":"Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei 10617, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuan-Pin","family":"Wang","sequence":"additional","affiliation":[{"name":"Center of Artificial Intelligence, China Medical University Hospital, Taichung 404327, Taiwan"},{"name":"Department of Computer Science and Engineering, National Chung Hsing University, Taichung 40227, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6099-7987","authenticated-orcid":false,"given":"You-Pen","family":"Chiu","sequence":"additional","affiliation":[{"name":"Spine Center, China Medical University Hospital, Taichung 404327, Taiwan"},{"name":"School of Medicine, China Medical University, Taichung 404327, Taiwan"},{"name":"Graduate Institute of Biomedical Science, China Medical University, Taichung 404327, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui-Ru","family":"Ji","sequence":"additional","affiliation":[{"name":"Spine Center, China Medical University Hospital, Taichung 404327, Taiwan"},{"name":"School of Medicine, China Medical University, Taichung 404327, Taiwan"},{"name":"Graduate Institute of Biomedical Science, China Medical University, Taichung 404327, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6368-3676","authenticated-orcid":false,"given":"Chia-Hung","family":"Kao","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung 404327, Taiwan"},{"name":"Center of Artificial Intelligence, China Medical University Hospital, Taichung 404327, Taiwan"},{"name":"Graduate Institute of Biomedical Science, China Medical University, Taichung 404327, Taiwan"},{"name":"Department of Bioinformatics and Medical Engineering, Asia University, Taichung 41354, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0369-0935","authenticated-orcid":false,"given":"Cheng-Di","family":"Chiu","sequence":"additional","affiliation":[{"name":"Spine Center, China Medical University Hospital, Taichung 404327, Taiwan"},{"name":"Department of Neurosurgery, China Medical University Hospital, Taichung 404327, Taiwan"},{"name":"School of Medicine, China Medical University, Taichung 404327, Taiwan"},{"name":"Graduate Institute of Biomedical Science, China Medical University, Taichung 404327, Taiwan"},{"name":"Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1007\/s00586-016-4714-y","article-title":"Total disc replacement versus fusion for lumbar degenerative disc disease: A systematic review of overlapping meta-analyses","volume":"26","author":"Ding","year":"2017","journal-title":"Eur. 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