A radiomics nomogram for the ultrasound-based evaluation of central cervical lymph node metastasis in papillary thyroid carcinoma

Abstract

PurposeTo develop and validate a radiomics nomogram based on ultrasound (US) to predict central cervical lymph node (LN) metastasis in patients with papillary thyroid carcinoma (PTC).MethodsPTC patients with pathologically confirmed presence or absence of central cervical LN metastasis in our hospital between March 2021 and November 2021 were enrolled as the training cohort. Radiomics features were extracted from the preoperative US images, and a radiomics signature was constructed. Univariate and multivariate logistic regression analyses were used to screen out the independent risk factors, and a radiomics nomogram was established. The performance of the model was verified in the independent test cohort of PTC patients who underwent thyroidectomy and cervical LN dissection in our hospital from December 2021 to March 2022.ResultsIn the independent test cohort, the radiomics model based on long-axis cross-section and short-axis cross-section images outperformed the radiomics models based on either one of these sections (the area under the curve (AUC), 0.69 vs. 0.62 and 0.66). The radiomics signature consisted of 4 selected features. The US radiomics nomogram included the radiomics signature, age, gender, BRAF V600E mutation status, and extrathyroidal extension (ETE) status. In the independent test cohort, the AUC of the receiver operating curve(ROC) of this nomogram was 0.76, outperformingthe clinical model and the radiomics model (0.63 and 0.69, respectively), and also much better than preoperative US examination (AUC, 0.60). Decision curve analysis indicated that the radiomics nomogram was clinically useful.ConclusionsThis study presents an efficient and useful US radiomics nomogram that can provide comprehensive information to assist clinicians in the individualized preoperative prediction of central cervical LN metastasis in PTC patients.

Update on the Applications of Radiomics in Diagnosis, Staging, and Recurrence of Intrahepatic Cholangiocarcinoma

“…Although the results of the ultrasomics model compared with LI-RADS were encouraging, the difference between the two scores in the ability to differentiate ICC from HCC was not significant [ 92 ]. The data obtained on liver ultrasomics were similar to those obtained on thyroid, breast, or kidney ultrasomics [ 95 , 96 , 97 , 98 , 99 , 100 , 101 ].…”

Quantitative ultrasound radiomics analysis to evaluate lymph nodes in patients with cancer: a systematic review

“…All 47 studies are summarized in Supplementary Table 1 [2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48] and were divided based on the tumor of origin: breast cancer, head and neck cancer, and cervical cancer. Most of the papers were published between 2019 and 2022 (n = 19 articles), and the analyses were conducted using MATLAB, R software, SPSS, OriginPro, a papillary thyroid carcinoma (PTC), cervical LN metastasis (LNM) prediction system (custom-built, n = 3), MIPAV, and Mazda.…”

“…Feature extraction was mainly performed with PyRadiomics, ITK-SNAP, LifeX, MedCalc, ImageJ, PASW and Prism. The values of the area under the curve (AUC), sensitivity, specificity, and accuracy are summarized in ▶ Table 1 [2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48].…”

“…Head and neck cancer studies mainly focused on thyroid cancer, specifically PTC and head and neck squamous cell carcinoma (HNSCC). We identified 20 studies investigating LN status in patients with PTC [13,14,15,16,17,18,19,20,21,22,23,32,35,36,37,38,46,47,48], one study on follicular thyroid carcinoma [25], one on treatment outcome prediction in head and neck malignancies [44], and three studies on HNSCC [29,30,31].…”

“…Most studies (n = 15 articles) on PTC showed that it is possible to predict lateral or central LNM using radiomics [13], although one study from Kim et al [14] was unsuccessful. Radiomics analysis included models combining shear-wave elastography and B-mode US combined Rad-score [16], strain elastography US and B-mode US [18], radiomics and clinical features [21,36,37,38,48], textural and radiological features [22], grayscale texture analysis [23], and clinical, radiomics, and extrathyroidal extension features [35].…”