A radiomics-driven approach for predicting response to induction therapy in multiple myeloma: Leveraging CT-based delta features

CT-based Delta radiomics constitutes a robust, non-invasive biomarker for MM response assessment. While 24hU-Pro serves as an indispensable biological reference, the multi-regional radiomic signature remains the primary engine of predictive power. This underscores the clinical necessity of quantitative, skeleton-aware analysis in steering individualized induction therapy. MM: Multiple myeloma; CT: Computed tomography; ROI: Region of interest; AUC: Area under the curve; ESM: Electronic supplementary material; WBLDCT: Whole-body low-dose computed tomography; IMWG: International Myeloma Working Group; LASSO: Least Absolute Shrinkage and Selection Operator; mRMR: minimum Redundancy Maximum Relevance; SVM: Support Vector Machine; RF: Random Forest; XGBoost: Extreme Gradient Boosting; GLCM: Gray-Level Co-occurrence Matrix; GLRLM: Gray-Level Run-Length Matrix; GLSZM: Gray-Level Size Zone Matrix; NGTDM: Neighboring Gray-Tone Difference Matrix; DSC: Dice Similarity Coefficient; DCA: Decision Curve Analysis.