Quantum kernel support vector machines for trabecular bone classification: comparing feature reduction strategies on synthetic micro-CT data

Quantum kernel methods offer a potential advantage for classification tasks in high-dimensional feature spaces, yet their practical benefit critically depends on how input features are prepared. We compare five dimensionality reduction strategies - principal component analysis (PCA), Gaussian random projection (RP Gaussian), sparse random projection (RP Sparse), partial least squares (PLS), and uniform manifold approximation and projection (UMAP) - as pre-processing steps for quantum kernel support vector machines (SVMs) applied to trabecular bone classification from synthetic micro-computed tomography (micro-CT) data. Using a custom procedural generator based on Gaussian random field zero-crossings, we produced 500 synthetic trabecular bone volumes with controlled morphometric properties such as bone volume fraction (BV/TV), trabecular thickness (Tb.Th), number (Tb.N) and spacing (Tb.Sp). Texture features extracted from grayscale slices are reduced to 8-dimensional quantum circuit inputs via each method, then classified using both classical radial basis function (RBF)-SVMs and quantum kernel SVMs with ZZ feature maps on a statevector simulator, both evaluated with 5x5 repeated stratified cross-validation (25 folds). Our results show that UMAP is the only reduction method where the quantum kernel remains competitive with the classical baseline. Under repeated cross-validation, UMAP showed a +0.032 accuracy gap favouring the quantum kernel (Dietterich 5x2 CV p = 0.177); however, validation on 10 fully independent datasets - each with independently generated samples, separate reduction fits, and separate kernel matrices - reversed the sign to -0.030 (paired t-test p = 0.123; Wilcoxon p = 0.193; quantum wins 3/10 datasets), indicating that the apparent advantage was likely inflated by fold dependence. Nevertheless, UMAP's gap remains small and non-significant in both analyses, whereas all linear methods (PCA, RP Gaussian, PLS) show substantial quantum deficits of -0.090 to -0.116 across BV/TV classification, with PCA and PLS remaining significant under corrected tests (5x2 CV p=0.004 and p=0.007 respectively). We additionally evaluate quantum kernel ridge regression for continuous morphometric prediction, finding that ZZ quantum kernels fail uniformly at regression (negative R2 for all methods except PLS at 4 qubits), suggesting that the ZZ kernel captures decision boundaries but not smooth metric structure. These findings provide practical guidance for feature engineering in near-term quantum machine learning pipelines and demonstrate that the choice of dimensionality reduction can determine whether quantum kernels remain competitive with classical baselines.