Evaluation of radiomic feature harmonization techniques for benign and malignant pulmonary nodules

BACKGROUND: Radiomics provides quantitative features of pulmonary nodules (PNs) which could aid lung cancer diagnosis, but medical image acquisition variability is an obstacle to clinical application. Acquisition effects may differ between radiomic features from benign vs. malignant PNs. PURPOSE: We evaluated how to account for differences between benign and malignant PNs when correcting radiomic features' acquisition dependency. METHODS: We used 567 chest CT scans grouped as benign, malignant, or lung cancer screening (mixed benign, malignant). ComBat harmonization was applied to extracted features for variation in 4 acquisition parameters. We compared: harmonizing without distinction, harmonizing with a covariate to preserve distinctions between subgroups, and harmonizing subgroups separately. Significant ($p\le0.05$) Kruskal-Wallis tests showed whether harmonization removed acquisition dependency. A LASSO-SVM pipeline was trained on successfully harmonized features to predict malignancy. To evaluate predictive information in these features, the trained harmonization estimators and predictive model were applied to unseen test sets. Harmonization and predictive performance were assessed for 10 trials of 5-fold cross-validation. RESULTS: An average 2.1% of features (95% CI:1.9-2.4%) were acquisition-independent when harmonized without distinction, 27.3% (95% CI:25.7-28.9%) when harmonized with a covariate, and 90.9% (95% CI:90.4-91.5%) when harmonized separately. Data harmonized separately or with a covariate trained models with higher ROC-AUC for screening scans than data harmonized without distinction between benign and malignant PNs (Delong test, adjusted $p\le0.05$). CONCLUSIONS: Radiomic features of benign and malignant PNs need different corrective transformations to recover acquisition-independent distributions. This can be done by harmonizing separately or with a covariate.