biostudies-literatureUnknown25(1)Bai D<h4>Objective</h4>This study aimed to develop an interpretable machine learning model integrating delayed-phase contrast-enhanced CT radiomics with clinical features for noninvasive prediction of pathological grading in appendiceal pseudomyxoma peritonei (PMP), using Shapley Additive Explanations (SHAP) for model interpretation.<h4>Materials and methods</h4>This retrospective study analyzed 158 pathologically confirmed PMP cases (85 low-grade, 73 high-grade) from January 4, 2015 to April 30, 2024. Comprehensive clinical data including demographic characteristics, serum tumor markers (CEA, CA19-9, CA125, D-dimer, CA-724, CA-242), and CT-peritoneal cancer index (CT-PCI) were collected. Radiomics features were extracted from preoperative contrast-enhanced CT scans using standardized protocolsBMC medical imaging300https://www.ebi.ac.uk/biostudies/studies/S-EPMC12306113biostudies-literatureA radiomics-based interpretable model integrating delayed-phase CT and clinical features for predicting the pathological grade of appendiceal pseudomyxoma peritonei.PMC12306113Bai DZheng ZLiang YLi FShi GWang ZfalseA radiomics-based interpretable model integrating delayed-phase CT and clinical features for predicting the pathological grade of appendiceal pseudomyxoma peritonei.<h4>Objective</h4>This study aimed to develop an interpretable machine learning model integrating delayed-phase contrast-enhanced CT radiomics with clinical features for noninvasive prediction of pathological grading in appendiceal pseudomyxoma peritonei (PMP), using Shapley Additive Explanations (SHAP) for model interpretation.<h4>Materials and methods</h4>This retrospective study analyzed 158 pathologically confirmed PMP cases (85 low-grade, 73 high-grade) from January 4, 2015 to April 30, 2024. Comprehensive clinical data including demographic characteristics, serum tumor markers (CEA, CA19-9, CA125, D-dimer, CA-724, CA-242), and CT-peritoneal cancer index (CT-PCI) were collected. Radiomics features were extracted from preoperative contrast-enhanced CT scans using standardized protocols2025-01-01T00:00:00Z2025 Jul2026-03-18T14:05:28.479Z2025-08-23T03:07:38.465ZS-EPMC123061134072201110.1186/s12880-025-01843-6