Radiomics and Clinical Features for Distinguishing Kidney Stone-Associated Urinary Tract Infection: A Comprehensive Analysis of Machine Learning Classification.

Background: This study investigated the abilities of radiomics and clinical feature models to distinguish kidney stone-associated urinary tract infections (KS-UTIs) using computed tomography. Methods: A retrospective analysis was conducted on a single-center dataset comprising computed tomography (CT) scans and corresponding clinical information from 461 patients with kidney stones. Radiomics features were extracted from CT images and underwent dimensionality reduction and selection. Multiple machine learning (Three types of shallow learning and four types of deep learning) algorithms were employed to construct radiomics and clinical models in this study. Performance evaluation and optimal model selection were done using receiver operating characteristic (ROC) curve analysis and Delong test. Univariate and multivariate logistic regression analyzed clinical and radiomics features to identify significant variables and develop a clinical model. A combined model integrating radiomics and clinical features was established. Model performance was assessed by ROC curve analysis, clinical utility was evaluated through decision curve analysis, and the accuracy of the model was analyzed via calibration curve. Results: Multilayer perceptron (MLP) showed higher classification accuracy than other classifiers (area under the curve (AUC) for radiomics model: train 0.96, test 0.94; AUC for clinical model: train 0.95, test 0.91. The combined radiomics-clinical model performed best (AUC for combined model: train 0.98, test 0.95). Decision curve and calibration curve analyses confirmed the model's clinical efficacy and calibration. Conclusions: This study showed the effectiveness of combining radiomics and clinical features from CT scans to identify KS-UTIs. A combined model using MLP exhibited strong classification abilities.