Discussion
necrotic, necrosis
MCC, NECROTIC, NECROSIS
Currently, there is a general consensus in the academic community on the criteria for assessing the efficacy of hip preservation [Both procedures integrated in this study were NVBG, but they had some differences. The lightbulb procedure can expose most of the femoral head, allowing the operator to remove necrotic bone thoroughly and fill it with autologous or allogeneic bone under direct vision [In this study, we applied radiomics to hip preservation. We screened a total of four radiomics features related to efficacy and five related to NVBG procedures, which we divided into the following two categories: (1) Shape feature describing the 3D size and shape of the ROI-Elongation, it shows the relationship between the two largest principal components in the ROI shape, and (2) Texture features-GLCM and GLDM, including MCC for complexity of the texture, Dependence Non-Uniformity Normalized for the similarity of dependence throughout the image, Mean, Joint Average, and Median for gray level intensity within the ROI. These radiomics features reflect the correlation between the extent, size, and local signal intensity of the necrotic area and efficacy of NVBG & NVBG procedures at the microscopic level.Roger [JIC is an independent clinical predictive variable associated with the efficacy and choice of NVBG procedures, reflecting the extent of necrosis and the degree of involvement of the lateral column. The extent and location of necrosis of the femoral head are recognized factors in the prognosis of the femoral head, and the integrity of the anterolateral column plays a vital role in maintaining the function of the femoral head [Of the three models constructed based on the above predictive variables, the C-R model outperformed the clinical model and the Radiomics model, with higher specificity and sensitivity both in the training cohort and validation cohort. Radiomics refers to the comprehensive quantification of the necrotic area by applying massive quantitative imaging features at the microscopic level, which may reflect changes in the femoral head at the cellular and genetic levels, and provides more detailed information on the necrotic area and microenvironment that are complementary to visual features [However, our study has several limitations: (1) This study was a retrospective single-center design, resulting in a small sample size and limited variety of surgical procedures, so multi-center, prospective, and large sample validation should be considered in future studies; (2) Our nomograms weren’t validated on an independent, external validation cohort, which would influence the predictive performance of the models. Furthermore, nomograms represent static models or algorithms and cannot easily be updated, a single and static graph is difficult to summarize the modern predictive modeling techniques and algorithm developments [