Using machine learning to develop a stacking ensemble learning model for the CT radiomics classification of brain metastases

The objective of this study was to explore the potential of machine-learning techniques in the automatic identification and classification of brain metastases from a radiomic perspective, aiming to improve the accuracy of tumor volume assessment for radiotherapy. By using various machine-learning algorithms, including random forest, support vector machine, gradient boosting machine, XGBoost, decision tree, artificial neural network, k-nearest neighbors, LightGBM, and CatBoost algorithms, a stacking ensemble model was developed to classify gross tumor volume (GTV), brainstem, and normal brain tissue based on radiomic features. Multiple evaluation metrics, including the specificity, sensitivity, negative predictive value, positive predictive value, accuracy, Matthews correlation coefficient, and the Youden index, were used to assess the model's performance. The stacked ensemble model integrated the strengths of the nine base models and consistently outperformed individual base models in classifying GTV (area under the curve [AUC] = 0.928), brainstem (AUC = 0.932), and normal brain tissue (AUC = 0.942). Among the base models, the support vector machine model demonstrated the best performance in the three classifications (AUC = 0.922, 0.909, and 0.928). The higher performance of the stacked ensemble model highlighted the low performance of other models, including the decision tree (AUC = 0.709, 0.706, 0.804) and k-nearest neighbors (AUC = 0.721, 0.663, 0.729) models in certain contexts, such as when faced with high-dimensional feature spaces. While machine learning shows significant promise in medical image analysis, relying solely on a single model may lead to suboptimal results. By combining the strengths of various algorithms, the stacking ensemble model offers a better solution for the classification of brain metastases based on radiomic features.