Prediction of Lumbar Drainage-Related Meningitis Based on Supervised Machine Learning Algorithms

Comparative study of different machine learning models in landslide susceptibility assessment: A case study of Conghua District, Guangzhou, China

Developing machine learning models with multi-source environmental data to predict wheat yield in China

BackgroundTranscutaneous transhepatic gallbladder drainage (PTGBD) has shown significant efficacy in the treatment of elderly patients with acute cholecystitis. The goal of this study is to develop a machine learning-based web calculator aimed at predicting the optimal timing for cholecystectomy (LC) after PTGBD in elderly patients with acute cholecystitis (AC) to achieve precise personalized medicine.MethodsA retrospective analysis of 979 elderly patients with acute cholecystitis admitted to Jinzhou Central Hospital and the First Affiliated Hospital of Jinzhou Medical University from 2013 to 2024 was performed, and a total of 680 patients were included in the model development. Patients were divided into delayed (347 cases, surgery > 6 weeks post-PTGBD) and non-delayed (333 cases) groups based on the interval between PTGBD and LC. Minimal Absolute Contraction and Selection Operator (LASSO) and logistic analysis were used to determine the predictors of postponement of LC in elderly patients with AC after PTGBD. Next, we used eight ML algorithms, namely Logistic Regression (LR), Decision Tree (DT), Random Forest (RF), Extreme gradient boosting (XGB), Support Vector Machine (SVM), Multilayer Perceptron (MLP), K-nearest Neighbor (KNN), Gaussian Naive Bayes (GNB), to train and develop ML models using a 10x cross-validation method. The performance of the model was evaluated by a variety of indicators, including the area under the receiver operating characteristic curve (ROC), calibration curve, decision curve, PR curve, and confusion matrix. In addition, model interpretation is performed through Shapley Additive Interpretation (SHAP) analysis to clarify the importance of each feature of the model and its basis for decision-making. Finally, we chose to use the best model to develop a web-based calculator that could be used to predict the likelihood of delaying LC after PTGBD in elderly AC patients.ResultsIn multivariate logistic regression analysis, age, sex, gallbladder wall thickness, time between onset and PTGBD, white blood cell count (WBC), C-reactive protein (CRP), and neutrophil-to-lymphocyte ratio (NLR) were identified as independent predictors of delayed LC in elderly patients with AC after PTGBD. In the training set, the area under the receiver operating characteristic curve (AUC) values for these models ranged from 0.808 to 0.914, with the random forest (RF) model showing the highest AUC value. Through the evaluation of decision curve analysis (DCA), precision-recall (PR) curve and calibration curve, the RF model showed superior clinical decision support and prediction performance compared with the other seven models. Finally, we used the RF model to build an online network calculator, which aims to accurately assist doctors in making more informed and accurate clinical decisions and promote the wide application of the model in clinical practice (https://zw17786325639.shinyapps.io/Postpone/).ConclusionsThis study developed and validated an RF model network calculator based on clinical indicator information to assess the likelihood of delaying LC after PTGBD in elderly patients with acute cholecystitis. This tool is expected to assist physicians in making more appropriate clinical decisions for patients.

Objectives:Mandible osteoradionecrosis (ORN) is one of the most severe toxicities in patients with head and neck cancer (HNC) undergoing radiotherapy (RT). The existing literature focuses on the correlation of mandible ORN and clinical and dosimetric factors. This study proposes the use of machine learning (ML) methods as prediction models for mandible ORN incidence.Methods:A total of 96 patients (ORN incidence ratio of 1:1) treated between 2011 and 2015 were selected from the local HNC toxicity database. Demographic, clinical and dosimetric data (based on the mandible dose–volume histogram) were considered as model variables. Prediction accuracy (measured using a stratified fivefold nested cross-validation), sensitivity, specificity, precision and negative predictive value were used to evaluate the prediction performance of a multivariate logistic regression (LR) model, a support vector machine (SVM) model, a random forest (RF) model, an adaptive boosting (AdaBoost) model and an artificial neural network (ANN) model. The different models were compared based on their prediction accuracy and using the McNemar’s hypothesis test.Results:The ANN model (77% accuracy), closely followed by the SVM (76%), AdaBoost (75%) and LR (75%) models, showed the highest overall prediction accuracy. The RF model (71%) showed the lowest prediction accuracy. However, based on the McNemar’s test applied to all model pair combinations, no statistically significant difference between the models was found.Conclusion:Based on our results, we encourage the use of ML-based prediction models for ORN incidence as has already been done for other HNC toxicity end points.Advances in knowledge:This research opens a new path towards personalised RT for HNC using ML to predict mandible ORN incidence.

To predict the potential geographic distribution of Oncomelania hupensis in Yunnan Province using random forest (RF) and maximum entropy (MaxEnt) models, so as to provide insights into O. hupensis surveillance and control in Yunnan Province. The O. hupensis snail survey data in Yunnan Province from 2015 to 2016 were collected and converted into O. hupensis snail distribution site data. Data of 22 environmental variables in Yunnan Province were collected, including twelve climate variables (annual potential evapotranspiration, annual mean ground surface temperature, annual precipitation, annual mean air pressure, annual mean relative humidity, annual sunshine duration, annual mean air temperature, annual mean wind speed, ≥ 0 ℃ annual accumulated temperature, ≥ 10 ℃ annual accumulated temperature, aridity and index of moisture), eight geographical variables (normalized difference vegetation index, landform type, land use type, altitude, soil type, soil textureclay content, soil texture-sand content and soil texture-silt content) and two population and economic variables (gross domestic product and population). Variables were screened with Pearson correlation test and variance inflation factor (VIF) test. The RF and MaxEnt models and the ensemble model were created using the biomod2 package of the software R 4.2.1, and the potential distribution of O. hupensis snails after 2016 was predicted in Yunnan Province. The predictive effects of models were evaluated through cross-validation and independent tests, and the area under the receiver operating characteristic curve (AUC), true skill statistics (TSS) and Kappa statistics were used for model evaluation. In addition, the importance of environmental variables was analyzed, the contribution of environmental variables output by the models with AUC values of > 0.950 and TSS values of > 0.850 were selected for normalization processing, and the importance percentage of environmental variables was obtained to analyze the importance of environmental variables. Data of 148 O. hupensis snail distribution sites and 15 environmental variables were included in training sets of RF and MaxEnt models, and both RF and MaxEnt models had high predictive performance, with both mean AUC values of > 0.900 and all mean TSS values and Kappa values of > 0.800, and significant differences in the AUC (t = 19.862, P < 0.05), TSS (t = 10.140, P < 0.05) and Kappa values (t = 10.237, P < 0.05) between two models. The AUC, TSS and Kappa values of the ensemble model were 0.996, 0.954 and 0.920, respectively. Independent data verification showed that the AUC, TSS and Kappa values of the RF model and the ensemble model were all 1, which still showed high performance in unknown data modeling, and the MaxEnt model showed poor performance, with TSS and Kappa values of 0 for 24%(24/100) of the modeling results. The modeling results of 79 RF models, 38 MaxEnt models and their ensemble models with AUC values of > 0.950 and TSS values of > 0.850 were included in the evaluation of importance of environmental variables. The importance of annual sunshine duration (SSD) was 32.989%, 37.847% and 46.315% in the RF model, the MaxEnt model and their ensemble model, while the importance of annual mean relative humidity (RHU) was 30.947%, 15.921% and 28.121%, respectively. Important environment variables were concentrated in modeling results of the RF model, dispersed in modeling results of the MaxEnt model, and most concentrated in modeling results of the ensemble model. The potential distribution of O. hupensis snails after 2016 was predicted to be relatively concentrated in Yunnan Province by the RF model and relatively large by the MaxEnt model, and the distribution of O. hupensis snails predicted by the ensemble model was mostly the joint distribution of O. hupensis snails predicted by RF and MaxEnt models. Both RF and MaxEnt models are effective to predict the potential distribution of O. hupensis snails in Yunnan Province, which facilitates targeted O. hupensis snail control.

Among older adults, type 2 diabetes mellitus (T2DM) is widely recognized as one of the most prevalent diseases. Diabetic nephropathy (DN) is a frequent complication of DM, mainly characterized by renal microvascular damage. Early detection, aggressive prevention, and cure of DN are key to improving prognosis. Establishing a diagnostic and predictive model for DN is crucial in auxiliary diagnosis. To investigate the factors that impact T2DM complicated with DN and utilize this information to develop a predictive model. The clinical data of 210 patients diagnosed with T2DM and admitted to the First People's Hospital of Wenling between August 2019 and August 2022 were retrospectively analyzed. According to whether the patients had DN, they were divided into the DN group (complicated with DN) and the non-DN group (without DN). Multivariate logistic regression analysis was used to explore factors affecting DN in patients with T2DM. The data were randomly split into a training set (n = 147) and a test set (n = 63) in a 7:3 ratio using a random function. The training set was used to construct the nomogram, decision tree, and random forest models, and the test set was used to evaluate the prediction performance of the model by comparing the sensitivity, specificity, accuracy, recall, precision, and area under the receiver operating characteristic curve. Among the 210 patients with T2DM, 74 (35.34%) had DN. The validation dataset showed that the accuracies of the nomogram, decision tree, and random forest models in predicting DN in patients with T2DM were 0.746, 0.714, and 0.730, respectively. The sensitivities were 0.710, 0.710, and 0.806, respectively; the specificities were 0.844, 0.875, and 0.844, respectively; the area under the receiver operating characteristic curve (AUC) of the patients were 0.811, 0.735, and 0.850, respectively. The Delong test results revealed that the AUC values of the decision tree model were lower than those of the random forest and nomogram models (P < 0.05), whereas the difference in AUC values of the random forest and column-line graph models was not statistically significant (P > 0.05). Among the three prediction models, random forest performs best and can help identify patients with T2DM at high risk of DN.

GIS-based mineral prospectivity mapping using machine learning methods: A case study from Tongling ore district, eastern China

Objective: Using methylation characteristics of human genes to construct machine learning predictive models for screening cervical cancer and precancerous lesions. Methods: Human DNA methylation detection was performed on 224 cervical exfoliated cell specimens from the Cancer Hospital of the Chinese Academy of Medical Sciences, Tianjin Central Hospital of Gynecology Obstetrics, Xinmi Maternal and Child Health Hospital of Henan Province, West China Second Affiliated Hospital of Sichuan University, and Heping Hospital Affiliated to Changzhi Medical College collected during April 2014 and March 2015. The hypermethylated gene fragments related to cervical cancer were selected by high-density, high-association, and hypermethylated gene fragment screening and the LASSO regression algorithm. Taking cervical intraepithelial neoplasia grade 2 (CIN2) or more severe lesions as the research outcome, machine learning predictive models based on the random forest (RF), naive Bayes (NB), and support vector machine (SVM) algorithm, respectively, were constructed. A total of 144 outpatient specimens were used as the training set and 80 cervical exfoliated cell specimens from women participating in the cervical cancer screening program were used as the test set to verify the predictive models. Using histological diagnosis results as the gold standard, the detection efficacy for CIN2 or more severe lesions of the three machine learning predictive models were compared with that of the human papilloma virus (HPV) detection and cytological diagnosis. Results: In the training set of 144 cases, there were 34 cases of HPV positivity, with a positive rate of 23.61%. Cytologically, there were 37 cases diagnosed as no intraepithelial lesion or malignancy (NILM), and 107 cases diagnosed as atypical squamous cells of undetermined significance (ASC-US) or above. Histologically, there were 28 cases without cervical intraepithelial neoplasia or benign cervical lesions, 31 cases of CIN1, 18 cases of CIN2, 31 cases of CIN3, and 36 cases of squamous cell carcinoma. Seven hypermethylated gene fragments were selected from 45 genes, and three machine learning prediction models based on the RF, NB, and SVM algorithm, respectively, were constructed. In the validation set of 80 cases, there were 28 cases of HPV positivity, with a positive rate of 35.00%. Cytologically, there were 65 cases diagnosed as NILM and 15 cases as ASC-US or above. Histologically, there were 39 cases without cervical intraepithelial neoplasia or benign cervical lesions, 10 cases of CIN1, 10 cases of CIN2, 11 cases of CIN3, and 10 cases of squamous cell carcinoma. In the validation set, the area under the curve (AUC) values of the RF model, NB model, SVM model, HPV detection, and cytological diagnosis of CIN2 or above were 0.90, 0.88, 0.82, 0.68, and 0.45, respectively. The DeLong test showed that there was no statistically significant difference in the AUC values between the RF, NB, and SVM models (all P＞0.05), and the AUC values of the RF and NB models were higher than that of HPV detection (both P＜0.01), and the AUC values of the RF, NB, and SVM models were higher than that of cytological diagnosis (all P＜0.01). Compared with the NB model, the sensitivity of the RF model was similar (80.65% vs. 77.42%), but the specificity of the NB model was much higher than that of the RF model (93.88% vs. 73.47%). Conclusion: Among the machine learning prediction models for cervical cancer and precancerous lesions constructed based on human DNA methylation, the NB model has good predictive performance for CIN2 and above lesions, and may be used for screening of cervical cancer and precancerous lesions.

PurposeMachine learning models were developed and validated to identify lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC) using clinical factors, laboratory metrics, and 2-deoxy-2[18F]fluoro-D-glucose ([18F]F-FDG) positron emission tomography (PET)/computed tomography (CT) radiomic features.MethodsOne hundred and twenty non-small cell lung cancer (NSCLC) patients (62 LUAD and 58 LUSC) were analyzed retrospectively and randomized into a training group (n = 85) and validation group (n = 35). A total of 99 feature parameters—four clinical factors, four laboratory indicators, and 91 [18F]F-FDG PET/CT radiomic features—were used for data analysis and model construction. The Boruta algorithm was used to screen the features. The retained minimum optimal feature subset was input into ten machine learning to construct a classifier for distinguishing between LUAD and LUSC. Univariate and multivariate analyses were used to identify the independent risk factors of the NSCLC subtype and constructed the Clinical model. Finally, the area under the receiver operating characteristic curve (AUC) values, sensitivity, specificity, and accuracy (ACC) was used to validate the machine learning model with the best performance effect and Clinical model in the validation group, and the DeLong test was used to compare the model performance.ResultsBoruta algorithm selected the optimal subset consisting of 13 features, including two clinical features, two laboratory indicators, and nine PEF/CT radiomic features. The Random Forest (RF) model and Support Vector Machine (SVM) model in the training group showed the best performance. Gender (P=0.018) and smoking status (P=0.011) construct the Clinical model. In the validation group, the SVM model (AUC: 0.876, ACC: 0.800) and RF model (AUC: 0.863, ACC: 0.800) performed well, while Clinical model (AUC:0.712, ACC: 0.686) performed moderately. There was no significant difference between the RF and Clinical models, but the SVM model was significantly better than the Clinical model. ConclusionsThe proposed SVM and RF models successfully identified LUAD and LUSC. The results indicate that the proposed model is an accurate and noninvasive predictive tool that can assist clinical decision-making, especially for patients who cannot have biopsies or where a biopsy fails.

Chronic Hepatitis B (CHB) is a leading cause of liver fibrosis. Accurate and non-invasive diagnosis of liver fibrosis in CHB patients is of critical clinical importance. This study aimed to develop and validate machine learning (ML)-based models for predicting significant liver fibrosis in CHB patients. This retrospective cohort study included 328 CHB patients (225 with non-significant liver fibrosis and 103 with significant liver fibrosis) from 2017 to 2022. Four ML models were constructed based on four selected features identified through the least absolute shrinkage and selection operator (LASSO) regression. Model performance was assessed using the receiver operating characteristic (ROC) curve, and the area under the curve (AUC), accuracy, sensitivity, specificity, and SHapley Additive exPlanations (SHAP) analysis. The random forest (RF) model demonstrated the highest predictive performance, with an AUC of 0.874 (95% CI: 0.813-0.934) in the training set and 0.863 (95% CI: 0.772-0.955) in the test set, outperforming extreme gradient boosting (XGBoost), logistic regression (LR), and support vector machine (SVM). Compared with the traditional fibrosis indices such as aspartate aminotransferase to platelet ratio index (APRI) (AUC = 0.585) and fibrosis-4 (FIB-4) (AUC = 0.633), the RF model (AUC = 0.863) demonstrated significantly higher predictive accuracy. SHAP analysis identified platelet count (PLT) as the most influential predictor in the RF model. The ML-based RF model offers a highly accurate, non-invasive interpretable tool for predicting significant liver fibrosis in patients with CHB, offering potential for clinical application in routine fibrosis risk assessment.

To construct and validate the best predictive model for 28-day death risk in patients with septic shock based on different supervised machine learning algorithms. The patients with septic shock meeting the Sepsis-3 criteria were selected from Medical Information Mart for Intensive Care-IV v2.0 (MIMIC-IV v2.0). According to the principle of random allocation, 70% of these patients were used as the training set, and 30% as the validation set. Relevant predictive variables were extracted from three aspects: demographic characteristics and basic vital signs, serum indicators within 24 hours of intensive care unit (ICU) admission and complications possibly affecting indicators, functional scoring and advanced life support. The predictive efficacy of models constructed using five mainstream machine learning algorithms including decision tree classification and regression tree (CART), random forest (RF), support vector machine (SVM), linear regression (LR), and super learner [SL; combined CART, RF and extreme gradient boosting (XGBoost)] for 28-day death in patients with septic shock was compared, and the best algorithm model was selected. The optimal predictive variables were determined by intersecting the results from LASSO regression, RF, and XGBoost algorithms, and a predictive model was constructed. The predictive efficacy of the model was validated by drawing receiver operator characteristic curve (ROC curve), the accuracy of the model was assessed using calibration curves, and the practicality of the model was verified through decision curve analysis (DCA). A total of 3 295 patients with septic shock were included, with 2 164 surviving and 1 131 dying within 28 days, resulting in a mortality of 34.32%. Of these, 2 307 were in the training set (with 792 deaths within 28 days, a mortality of 34.33%), and 988 in the validation set (with 339 deaths within 28 days, a mortality of 34.31%). Five machine learning models were established based on the training set data. After including variables at three aspects, the area under the ROC curve (AUC) of RF, SVM, and LR machine learning algorithm models for predicting 28-day death in septic shock patients in the validation set was 0.823 [95% confidence interval (95%CI) was 0.795-0.849], 0.823 (95%CI was 0.796-0.849), and 0.810 (95%CI was 0.782-0.838), respectively, which were higher than that of the CART algorithm model (AUC = 0.750, 95%CI was 0.717-0.782) and SL algorithm model (AUC = 0.756, 95%CI was 0.724-0.789). Thus above three algorithm models were determined to be the best algorithm models. After integrating variables from three aspects, 16 optimal predictive variables were identified through intersection by LASSO regression, RF, and XGBoost algorithms, including the highest pH value, the highest albumin (Alb), the highest body temperature, the lowest lactic acid (Lac), the highest Lac, the highest serum creatinine (SCr), the highest Ca2+, the lowest hemoglobin (Hb), the lowest white blood cell count (WBC), age, simplified acute physiology score III (SAPS III), the highest WBC, acute physiology score III (APS III), the lowest Na+, body mass index (BMI), and the shortest activated partial thromboplastin time (APTT) within 24 hours of ICU admission. ROC curve analysis showed that the Logistic regression model constructed with above 16 optimal predictive variables was the best predictive model, with an AUC of 0.806 (95%CI was 0.778-0.835) in the validation set. The calibration curve and DCA curve showed that this model had high accuracy and the highest net benefit could reach 0.3, which was significantly outperforming traditional models based on single functional score [APS III score, SAPS III score, and sequential organ failure assessment (SOFA) score] with AUC (95%CI) of 0.746 (0.715-0.778), 0.765 (0.734-0.796), and 0.625 (0.589-0.661), respectively. The Logistic regression model, constructed using 16 optimal predictive variables including pH value, Alb, body temperature, Lac, SCr, Ca2+, Hb, WBC, SAPS III score, APS III score, Na+, BMI, and APTT, is identified as the best predictive model for the 28-day death risk in patients with septic shock. Its performance is stable, with high discriminative ability and accuracy.

The effects of the spatial resolution of remote sensing (RS) data on wildfire susceptibility prediction are not fully understood. In this study, we evaluate the effects of coarse (Landsat 8 and SRTM) and medium (Sentinel-2 and ALOS) spatial resolution data on wildfire susceptibility prediction using random forest (RF) and support vector machine (SVM) models. In addition, we investigate the fusion of the predictions from the different spatial resolutions using the Dempster–Shafer theory (DST) and 14 wildfire conditioning factors. Seven factors are derived separately from the coarse and medium spatial resolution datasets for the whole forest area of the Guilan Province, Iran. All conditional factors are used to train and test the SVM and RF models in the Google Earth Engine (GEE) software environment, along with an inventory dataset from comprehensive global positioning system (GPS)-based field survey points of wildfire locations. These locations are evaluated and combined with coarse resolution satellite data, namely the thermal anomalies product of the moderate resolution imaging spectroradiometer (MODIS) for the period 2009 to 2019. We assess the performance of the models using four-fold cross-validation by the receiver operating characteristic (ROC) curve method. The area under the curve (AUC) achieved from the ROC curve yields 92.15% and 91.98% accuracy for the respective SVM and RF models for the coarse RS data. In comparison, the AUC for the medium RS data is 92.5% and 93.37%, respectively. Remarkably, the highest AUC value of 94.71% is achieved for the RF model where coarse and medium resolution datasets are combined through DST.

The glass transition temperatures (T gs) of materials used in the manufacture of organic light-emitting diodes (OLEDs) determine their thermal stability. Three Dragon descriptors, TPC, RBF and TDB04s, were adopted to develop quantitative structure-property relationships (QSPR) for the prediction of the T gs of 66 compounds (Data Set I) for OLED application, by applying random forest (RF) and support vector machine (SVM). The RF Model A, based on a training set (44 compounds), was validated with a test set (22 compounds). The RF Model A possesses a coefficient of determination R 2 of 0.942 and a root mean square (rms) error of 10.750 K for the training set and R 2 of 0.909 and rms error of 11.102 K for the test set, which are more accurate than the results from the SVM model. The RF Model A was further validated with 63 OLED molecules (Data Set II). Moreover, the three Dragon descriptors (TPC, RBF and TDB04s) were used to build another T g QSPR model (named RF Model B) for a large dataset of 1934 OLED molecules (Data Set III), which achieved rms errors of 16.79 K for Data Set III, 22.89 K for Data Set I and 20.17 K for Data Set II.

Background Predicting the prognosis of patients with acute myocardial infarction (AMI) combined with diabetes mellitus (DM) is crucial due to high in-hospital mortality rates. This study aims to develop and validate a mortality risk prediction model for these patients by interpretable machine learning (ML) methods. Methods Data were sourced from the Medical Information Mart for Intensive Care IV (MIMIC-IV, version 2.2). Predictors were selected by Least absolute shrinkage and selection operator (LASSO) regression and checked for multicollinearity with Spearman’s correlation. Patients were randomly assigned to training and validation sets in an 8:2 ratio. Seven ML algorithms were used to construct models in the training set. Model performance was evaluated in the validation set using metrics such as area under the curve (AUC) with 95% confidence interval (CI), calibration curves, precision, recall, F1 score, accuracy, negative predictive value (NPV), and positive predictive value (PPV). The significance of differences in predictive performance among models was assessed utilising the permutation test, and 10-fold cross-validation further validated the model’s performance. SHapley Additive exPlanations (SHAP) and Local Interpretable Model-agnostic Explanations (LIME) were applied to interpret the models. Results The study included 2,828 patients with AMI combined with DM. Nineteen predictors were identified through LASSO regression and Spearman’s correlation. The Random Forest (RF) model was demonstrated the best performance, with an AUC of 0.823 (95% CI: 0.774–0.872), high precision (0.867), accuracy (0.873), and PPV (0.867). The RF model showed significant differences (p < 0.05) compared to the K-Nearest Neighbours and Decision Tree models. Calibration curves indicated that the RF model’s predicted risk aligned well with actual outcomes. 10-fold cross-validation confirmed the superior performance of RF model, with an average AUC of 0.828 (95% CI: 0.800–0.842). Significant Variables in RF model indicated that the top eight significant predictors were urine output, maximum anion gap, maximum urea nitrogen, age, minimum pH, maximum international normalised ratio (INR), mean respiratory rate, and mean systolic blood pressure. Conclusion This study demonstrates the potential of ML methods, particularly the RF model, in predicting in-hospital mortality risk for AMI patients with DM. The SHAP and LIME methods enhance the interpretability of ML models.

BackgroundA considerable portion of patients with fever of unknown origin (FUO) present concomitant lymphadenopathy. Diseases within the spectrum of FUO accompanied by lymphadenopathy include lymphoma, infections, and rheumatic diseases. Particularly, lymphoma has emerged as the most prevalent etiology of FUO with associated lymphadenopathy. Distinguishing between benign and malignant lymph node lesions is a major challenge for physicians and an urgent clinical concern for patients. However, conventional imaging techniques, including PET/CT, often have difficulty accurately distinguishing between malignant and benign lymph node lesions. This study utilizes PET/CT radiomics to differentiate between lymphoma and benign lymph node lesions in patients with FUO, aiming to improve diagnostic accuracy.ResultsData were collected from 204 patients who underwent 18F-FDG PET/CT examinations for FUO, including 114 lymphoma patients and 90 patients with benign lymph node lesions. Patients were randomly divided into training and testing groups at a ratio of 7:3. A total of 15 effective features were obtained by the least absolute shrinkage and selection operator (LASSO) algorithm. Machine learning models were constructed using logistic regression (LR), support vector machine (SVM), random forest (RF), and k-nearest neighbors (KNN) algorithms. In the training group, the area under the curve (AUC) values for predicting lymphoma and benign cases by LR, SVM, RF, and KNN models were 0.936, 0.930, 0.998, and 0.938, respectively. There were statistically significant differences in AUC between the RF and other models (all P < 0.001). In the testing group, the AUC values for the four models were 0.860, 0.866, 0.915, and 0.891, respectively, with no statistically significant differences observed among them (all P > 0.05). The decision curve analysis (DCA) curves of the RF model outperformed those of the other three models in both the training and testing groups.ConclusionsPET/CT radiomics demonstrated promising performance in discriminating lymphoma from benign lymph node lesions in patients with FUO, with the RF model showing the best performance.