Machine learning outperforms deep learning in adhesive capsulitis diagnosis: a clinical-radiomics model bridging PD-T2 MRI and multimodal data fusion

Background

Adhesive Capsulitis of the Shoulder (ACS) is a chronic inflammatory condition characterized by capsular fibrosis, thickening, and restricted mobility. Early diagnosis remains challenging due to the limited sensitivity of traditional imaging and symptom-based methods.

Purpose

This study developed a clinical-multi-sequence radiomics model by integrating clinical data with magnetic resonance imaging (MRI) radiomics to enhance ACS detection and compared machine learning (ML) and deep learning (DL) approaches.

Methods

A total of 444 patients from two medical centers were retrospectively included and divided into a primary cohort (n = 387) and an external test cohort (n = 57). Radiomic features were extracted from proton density-weighted coronal (PD-COR) and T2-weighted sagittal (T2-SAG) MRI sequences using PyRadiomics, while deep learning features were obtained from ResNet-200 and Vision Transformer (ViT) models. ML models were developed using Support Vector Machine (SVM), Extreme Gradient Boosting (XGBoost), and Light Gradient Boosting machine (LightGBM). The clinical-multi-sequence radiomics model was constructed by integrating radiomic and clinical features, with performance assessed via the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity, and Brier Score.

Results

The PD_T2_LightGBM model achieved optimal performance (AUC: 0.975 training, 0.915 validation, 0.886 test), surpassing DL features models. The Clinical-Radiomics Combined model showed robust generalization (AUC: 0.981 training, 0.935 validation, 0.882 test). DL features models exhibited high sensitivity but reduced external validation accuracy.

Conclusion

Integrating clinical and radiomic features significantly improved diagnostic precision. While DL features models provide valuable feature extraction capabilities, traditional ML models like LightGBM exhibit superior stability and interpretability, making them suitable for clinical applications. Future efforts should prioritize larger datasets and advanced fusion techniques to refine ACS diagnosis.