Predicting the risk of type 2 diabetes mellitus (T2DM) emergence in 5 years using mammography images: a comparison study between radiomics and deep learning algorithm.

Purpose: The prevalence of type 2 diabetes mellitus (T2DM) has been steadily increasing over the years. We aim to predict the occurrence of T2DM using mammography images within 5 years using two different methods and compare their performance. Approach: We examined 312 samples, including 110 positive cases (developed T2DM after 5 years) and 202 negative cases (did not develop T2DM) using two different methods. In the first method, a radiomics-based approach, we utilized radiomics features and machine learning (ML) algorithms. The entire breast region was chosen as the region of interest for extracting radiomics features. Then, a binary breast image was created from which we extracted 668 features and analyzed them using various ML algorithms. In the second method, a complex convolutional neural network (CNN) with a modified ResNet architecture and various kernel sizes was applied to raw mammography images for the prediction task. A nested, stratified five-fold cross-validation was done for both parts A and B to compute accuracy, sensitivity, specificity, and area under the receiver operating curve (AUROC). Hyperparameter tuning was also done to enhance the model's performance and reliability. Results: The radiomics approach's light gradient boosting model gave 68.9% accuracy, 30.7% sensitivity, 89.5% specificity, and 0.63 AUROC. The CNN method achieved an AUROC of 0.58 over 20 epochs. Conclusion: Radiomics outperformed CNN by 0.05 in terms of AUROC. This may be due to the more straightforward interpretability and clinical relevance of predefined radiomics features compared with the complex, abstract features learned by CNNs.