## 5 Conclusions  
High morbidity and mortality still occur in patients who are diagnosed with IE. Despite recent improvements in diagnostic criteria due to the incorporation of medical imaging as one of the major criteria, there is still some ambiguity in the protocols, as well as a high false positive rate in the case of PVE, leaving room for improvement. Radiomic technology based on the information extracted from the images may lead to a significant improvement in the early detection of PVE, with a consequent enhancement in the sensitivity and specificity of the current diagnostic criteria. In the present study, the utility of potential radiomic-based biomarkers in the diagnosis of PVE in NAC [18]FDG PET/CT images has been evaluated. While initial findings indicate that a radiomic-based approach holds promise for enhancing PVE diagnostic sensitivity, future studies will be required to validate the use of this technology as a valuable tool to support the current PVE diagnostic criteria. The following supporting information can be downloaded at: [[https://www.mdpi.com/article/10.3390/app14062296/s1](https://www.mdpi.com/article/10.3390/app14062296/s1)]([https://www.mdpi.com/article/10.3390/app14062296/s1](https://www.mdpi.com/article/10.3390/app14062296/s1)), Table S1: Case-by-case tabulation of the individual subjects and their clinical outcome. Table S2: Hyperparameters of the ML models for Confirmed PVE and Discarded PVE classification. ; Table S3: Performances of ML models based on all the extracted radiomic features for Confirmed PVE and Discarded PVE classification. Figure S1: Nonparametric Spearman correlations were calculated between the remaining radiomic features post-univariate and reproducibility analyses, with highly correlated features (\(\rho\geq 0.9\)) discarded to mitigate multicollinearity issues. Conceptualization: D.P.-F., A.G.-G., A.P.S., H.B., E.J.G. and PS.-G.; Methodology: D.P.-F., A.G.-G., A.P.S. and PS.-G.; Software: D.P.-F. and A.P.S. ; Validation: D.P.-F., A.G.-G., A.P.S. and PS.-G.; Formal analysis: D.P.-F. and A.P.S. ; Investigation: D.P.-F., A.G.-G., A.P.S., H.B., E.J.G. and PS.-G.; Resources: A.G.-G., H.B., E.J.G. and PS.-G.; Data Curation: D.P.-F., A.G.-G. and A.P.S. ; Writing--Projial Draft Preparation: D.P.-F., A.G.-G., A.P.S. and PS.-G.; Writing--Review and Editing: D.P.-F., A.G.-G., A.P.S., H.B., E.J.G. and PS.-G.; Visualization: D.P.-F., A.P.S. and PS.-G.; Supervision: [PERSON]-G. All authors have read and agreed to the published version of the manuscript. This study was partially funded by Sociedad Espanola de Cardiologia (SEC/FEC-INV-BAS 22/023). The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board (or Ethics Committee) of the Hospital Universitario 12 October (internal code 23/650). Informed Consent Statement: Informed consent was obtained from all subjects involved in the study. The data presented in this study are available upon request from the corresponding authors. Clinical records will be anonymized to mask individual identities. The pre-processing scripts or settings as well as the source code for modeling are available from the corresponding author upon reasonable request. The authors declare no conflicts of interest. References  
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