Using ultrasound features and radiomics analysis to predict lymph node metastasis in patients with thyroid cancer
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RESEARCH ARTICLE
Using ultrasound features and radiomics analysis to predict lymph node metastasis in patients with thyroid cancer Fu Li1, Denghua Pan2, Yun He2, Yuquan Wu2, Jinbo Peng2, Jiehua Li1, Ye Wang1, Hong Yang2* and Junqiang Chen1*
Abstract Background: Lymph node metastasis (LNM) is an important factor for thyroid cancer patients’ treatment and prognosis. The aim of this study was to explore the clinical value of ultrasound features and radiomics analysis in predicting LNM in thyroid cancer patients before surgery. Methods: The characteristics of ultrasound images of 150 thyroid nodules were retrospectively analysed. All nodules were confirmed as thyroid cancer. Among the assessed patients, only one hundred and twenty-six patients underwent lymph node dissection. All patients underwent an ultrasound examination before surgery. In the radiomic analysis, the area of interest was identified from selected ultrasound images by using ITK-SNAP software. The radiomic features were extracted by using Ultrosomics software. Then, the data were classified into a training set and a validation set. Hypothetical tests and bagging were used to build the model. The diagnostic performance of different ultrasound features was assessed, a radiomic analysis was conducted, and a receiver operating characteristic (ROC) curve analysis was performed to explore the diagnostic accuracy. Results: Regarding the prediction of LNM, the ROC curves showed that the area under the curve (AUC) values of an irregular shape and microcalcification were 0.591 (P = 0.059) and 0.629 (P = 0.007), respectively. In the radiomics analysis, in the training set, the AUC value of LNM was 0.759, with a sensitivity of 0.90 and a specificity of 0.860. In the verification set, the AUC was 0.803, with a sensitivity of 0.727 and a specificity of 0.800. Conclusions: Microcalcification and an irregular shape are predictors of LNM in thyroid carcinoma patients. In addition, radiomics analysis has promising value in screening meaningful ultrasound features in thyroid cancer patients with LNM. Therefore, the prediction of LNM based on ultrasound features and radiomic features is useful for making appropriate decisions regarding surgery and interventions before thyroid carcinoma surgery. Keywords: Thyroid carcinoma, Lymph node metastasis, Ultrasound, Radiomic analysis
*Correspondence: [email protected]; [email protected] † Fu Li and Denghua Pan considered to be the first author 1 Department of Gastrointestinal Surgery, First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning 530021, Guangxi Zhuang Autonomous Region, People’s Republic of China 2 Department of Ultrasonography, First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning 530021, Guangxi Zhuang Autonomous Region, People’s Republic of China
Background Thyroid nodules are frequently found by clinicians, but thyroidectomy is needed for only a subset of thyroid nodules. Most types of thyroid cancer are described as indolent carcinomas t
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