Mycoses
CT-Based Clinical-Radiomics for Differentiating Talaromyces marneffei Spondylitis From Tuberculous Spondylitis Before Pathogen Confirmation: A Multicentre Diagnostic Study in an Endemic Region
By Zhao X, Teng Y, Wu G and 6 others.
Abstract
Background
Talaromyces marneffei spondylitis (TMS) is an uncommon but clinically important form of talaromycosis in endemic regions. Where talaromycosis and tuberculosis overlap, TMS may be worked up as tuberculous spondylitis (TBS), delaying fungal investigations and antifungal treatment.
Objectives
To assess whether pretreatment CT, routine clinical variables and radiomics features can help differentiate TMS from TBS at the initial assessment stage.
Patients/methods
This retrospective multicentre study included 263 patients meeting the prespecified composite reference standard (83 TMS and 180 TBS). Centre A formed the training and internal-validation cohorts; Centres B and C formed the external cohort (n = 50; 16 TMS and 34 TBS). Six clinical variables and 14 CT radiomics features were used to develop clinical, radiomics and combined models.