Habitat radiomics assists radiologists in accurately diagnosing lymph node metastasis of adenocarcinoma of the esophagogastric junction

Abstract Objectives This study aimed to develop a habitat radiomics (HR) model capable of preoperatively predicting lymph node metastasis (LNM) in adenocarcinoma of the esophagogastric junction (AEG) and to implement its use in clinical practice. Methods In this retrospective analysis, 337 patients from three centers were enrolled and divided into three cohorts: training, validation, and test (208, 52, and 77 patients, respectively). We constructed HR models, conventional radiomics models, and combined models to identify LNM in AEG. The area under the curve (AUC) was employed to identify the optimal model, which was then evaluated for assisting radiologists in the empirical and RADS groups in diagnosing LNM. Finally, the prediction process of the optimal model was visualized using SHAP plots. Results The HR model demonstrated superior performance, achieving the highest AUC values of 0.876, 0.869, and 0.795 in the training, validation, and test cohorts, respectively. Regardless of seniority, the empirical group of radiologists showed a significant improvement in the AUC and accuracy when using the HR model, compared to working alone (p