An arterial spin labeling-based radiomics signature and machine learning for the prediction and detection of various stages of kidney damage due to diabetes

The aim of this study was to assess the predictive capabilities of a radiomics signature obtained from arterial spin labeling (ASL) imaging in forecasting and detecting stages of kidney damage in patients with diabetes mellitus (DM), as well as to analyze the correlation between texture feature parameters and biological clinical indicators. Additionally, this study seeks to identify the imaging risk factors associated with early renal injury in diabetic patients, with the ultimate goal of offering novel insights for predicting and diagnosing early renal injury and its progression in patients with DM. In total, 42 healthy volunteers (Group A); 68 individuals with diabetes (Group B) who exhibited microalbuminuria, defined by a urinary albumin-to-creatinine ratio (ACR)< 30 mg/g and an estimated glomerular filtration rate (eGFR) within the range of 60-120 mL/min/1.73m²; and 53 patients with diabetic nephropathy (Group C) were included in the study. ASL using magnetic resonance imaging (MRI) at 3.0T was conducted. The radiologist manually delineated regions of interest (ROIs) on the ASL maps of both the right and left kidney cortex. Texture features from the ROIs were extracted utilizing MaZda software. Feature selection was performed utilizing a range of methods, such as the Fisher coefficient, mutual information (MI), probability of classification error, and average correlation coefficient (POE + ACC). A radiomics model was developed to detect early diabetic renal injury, extract imaging risk factors associated with early diabetic renal injury, and examine the relationship between significant texture feature parameters and biological clinical indicators. Patients with DM and kidney injury were followed prospectively. The study utilized seven machine learning algorithms to develop a detective radiomics model and a comprehensive predictive model for assessing the progression of kidney damage in patients with DM. The diagnostic efficacy of the models in detecting variations in diabetic kidney damage over time was evaluated using the area under the curve (AUC) of the receiver operating characteristic (ROC) curve. Empower (R) was used to establish a correlation between clinical biological indicators and texture feature metrics. Statistical analysis was conducted using R, Python, MedCalc 15.8, and GraphPad Prism 8. A total of 367 texture features were extracted from the ROIs in the kidneys and refined based on selection criteria using MaZda software across groups A