Pilot Exploratory Study of a CT Radiomics Model for the Classification of Small Cell Lung Cancer and Non-Small-Cell Lung Cancer in the Moscow Population: A Step Toward Virtual Biopsy

Lung cancer is one of the most common and socially significant cancers worldwide and consists of two main subtypes: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC), which require different treatments. Computed tomography (CT) scans cannot reliably differentiate these subtypes, often necessitating invasive biopsies that carry significant risks. Radiomics offers a promising non-invasive alternative by quantitatively analyzing imaging data to extract detailed tissue characteristics beyond visual assessment. This pilot retrospective study analyzed 200 Moscow patients with histologically confirmed SCLC or NSCLC. Manual tumor segmentation on pretreatment CT scans allowed extraction of 107 radiomic features, from which 16 key features were selected to train four machine learning models. Models were evaluated using stratified 5-fold cross-validation, focusing on ROC AUC, accuracy, precision, and recall. All models demonstrated strong performance in distinguishing SCLC from NSCLC, with the gradient boosting model achieving the highest accuracy of 80.5% and ROC AUC of 0.888. These results highlight the potential of radiomics combined with machine learning to enable accurate, non-invasive differentiation of lung cancer subtypes. Further research is needed to expand feature sets, develop automated segmentation tools, and enhance clinical application of this approach.