Feasibility study of differentiating patients with levodopa-induced dyskinesia using cerebellar gray and white matter radiomics features from 3DT1WI images.

Background: Levodopa therapy effectively treats Parkinson's disease (PD) motor symptoms but causes Levodopa-Induced Dyskinesia (LID) in some patients long-term. Cerebellar changes exist in LID cases; however, radiomics models based on this region haven't been evaluated for diagnostic use. We built diagnostic model using cerebellar structural radiomics from 3D T1WI to non-invasively diagnose LID. Methods: In this study, we retrospectively collected 3D T1WI data from the Parkinson's Progression Markers Initiative (PPMI) database, including data from 69 LID patients and 142 non-LID (N-LID) patients. These data were randomly split into a training set and a testing set at an 8:2 ratio. Using Fastsurfer segmentation, we identified four regions of interest (ROIs) corresponding to the left and right cerebellar gray matter and white matter. Python scripts were employed to independently extract radiomic features from each ROI. Subsequent steps involved feature selection and model construction. After selecting the optimal model, its performance was evaluated and validated. Finally, the SHAP method was used for model visualization. Results: Ultimately, the most representative 13 radiomic features were used for modeling. The model built based on the XGBoost algorithm achieved an AUC value of 0.962 on the training set and 0.849 on the testing set. Conclusion: The radiomic model extracted from the cerebellar gray and white matter effectively distinguishes between LID and N-LID patients. It offers a novel perspective on the heterogeneous characteristics of LID patients, significantly enhancing diagnostic performance and providing auxiliary support for clinical diagnosis.