Application of Fractal Radiomics and Machine Learning for Differentiation of Non-Small Cell Lung Cancer Subtypes on PET/MR Images

<b>Objectives:</b> Non-small cell lung cancer (NSCLC), the most prevalent type of lung cancer, includes subtypes such as adenocarcinoma (ADC) and squamous cell carcinoma (SCC), which require distinct management approaches. Accurately differentiating NSCLC subtypes based on diagnostic imaging remains challenging. However, the extraction of radiomic features-such as first-order statistics (FOS), second-order statistics (SOS), and fractal dimension texture analysis (FDTA) features-from magnetic resonance (MR) images supports the development of quantitative NSCLC assessments. <b>Methods:</b> This study aims to evaluate whether the integration of FDTA features with FOS and SOS texture features in MR image analysis improves machine learning classification of NSCLC into ADC and SCC subtypes. The study was conducted on 274 MR images, comprising ADC (n = 122) and SCC (n = 152) cases. From the segmented MR images, 93 texture features were extracted. The random forest algorithm was used to identify informative features from both FOS/SOS and combined FOS/SOS/FDTA datasets. Subsequently, the k-nearest neighbors (kNN) algorithm was applied to classify MR images as ADC or SCC. <b>Results:</b> The highest performance (accuracy = 0.78, precision = 0.81, AUC = 0.89) was achieved using 37 texture features selected from the combined FOS/SOS/FDTA dataset. <b>Conclusions:</b> Incorporating fractal descriptors into the texture-based classification of lung MR images enhances the differentiation of NSCLC subtypes.