Predicting Extrathyroidal Extension in Papillary Thyroid Carcinoma Using a Clinical-Radiomics Nomogram Based on B-Mode and Contrast-Enhanced Ultrasound
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients
2.2. BMUS and CEUS Examination
2.3. Clinicoradiological Data Acquisition
2.4. Image Segmentation and Feature Extraction
2.5. Feature Selection and Model Construction
2.6. Model Comparison and Nomogram Development
2.7. Statistical Analysis
3. Results
3.1. Clinico-Pathological Information
3.2. Radiomics Scores
wavelet.HLL_gldm_DependenceVariance + 0.5294 × wavelet.HLL_ngtdm_Complexity
3.3. Clinical Model
3.4. Clinical-Radiomics Model
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | Training Set (n = 152) | Validation Set (n = 64) | p-Value |
---|---|---|---|
Extrathyroidal extension | 0.579 | ||
Negative | 101 (66.4) | 45 (70.3) | |
Positive | 51 (33.6) | 19 (29.7) | |
Age | 0.622 | ||
<55 years | 124 (81.6) | 54 (84.4) | |
≥55 years | 28 (18.4) | 10 (15.6) | |
Gender | 0.919 | ||
Female | 113 (74.3) | 48 (75.0) | |
Male | 39 (25.7) | 16 (25.0) | |
Primary site | 0.537 | ||
Left lobe | 66 (43.4) | 31 (48.4) | |
Right lobe | 76 (50.0) | 31 (48.4) | |
Isthmus | 10 (6.6) | 2 (3.1) | |
Tumor size | 0.266 | ||
≤10 mm | 100 (65.8) | 37 (57.8) | |
>10 mm | 52 (34.2) | 27 (42.2) | |
Echogenicity | 0.120 | ||
Iso/hyperechoic | 6 (3.9) | 5 (7.8) | |
Hypoechoic | 53 (34.9) | 29 (45.3) | |
Marked hypoechoic | 93 (61.2) | 30 (46.9) | |
Aspect ratio > 1 | 0.381 | ||
Absent | 95 (62.5) | 44 (68.8) | |
Present | 57 (37.5) | 20 (31.2) | |
Margin | 0.133 | ||
Smooth | 6 (3.9) | 7 (10.9) | |
Ill-defined | 20 (13.2) | 9 (14.1) | |
Irregular | 126 (82.9) | 48 (75.0) | |
Microcalcification | 0.222 | ||
Absent | 43 (28.3) | 13 (20.3) | |
Present | 109 (71.7) | 51 (79.7) | |
Enhancement degree | 0.974 | ||
Hyper-enhancement | 7 (4.6) | 3 (4.7) | |
Iso-enhancement | 33 (21.7) | 13 (20.3) | |
Hypo-enhancement | 112 (73.7) | 48 (75) | |
BMUS-reported ETE | 0.886 | ||
Negative | 80 (52.6) | 33 (51.6) | |
Positive | 72 (47.4) | 31 (48.4) | |
CEUS-reported ETE | 0.523 | ||
Negative | 110 (72.4) | 49 (76.6) | |
Positive | 42 (27.6) | 15 (23.4) | |
BMUS Radscore, | 0.438 | ||
Median (interquartile range) | −1.01 (−1.29, −0.48) | −0.90 (−1.30, −0.35) | |
CEUS Radscore, | 0.317 | ||
Median (interquartile range) | −0.84 (−1.68, −0.11) | −0.64 (−1.29, −0.03) |
Characteristics | Training Set | Validation Set | ||||
---|---|---|---|---|---|---|
ETE− | ETE+ | p-Value | ETE− | ETE+ | p-Value | |
Age | 0.003 | 0.466 | ||||
<55 years | 89 (88.1) | 35 (68.6) | 39 (86.7) | 15 (78.9) | ||
≥55 years | 12 (11.9) | 16 (31.4) | 6 (13.3) | 4 (21.1) | ||
Gender | 0.252 | 0.530 | ||||
Female | 78 (77.2) | 35 (68.6) | 35 (77.8) | 13 (68.4) | ||
Male | 23 (22.8) | 16 (31.4) | 10 (22.2) | 6 (31.6) | ||
Primary site | 0.338 | 1.000 | ||||
Left lobe | 42 (41.6) | 24 (47.1) | 22 (48.9) | 9 (47.4) | ||
Right lobe | 54 (53.5) | 22 (43.1) | 21 (46.7) | 10 (52.6) | ||
Isthmus | 5 (5.0) | 5 (9.8) | 2 (4.4) | 0 (0.0) | ||
Tumor size | 0.002 | 0.006 | ||||
>10 mm | 75 (74.3) | 25 (49) | 31 (68.9) | 6 (31.6) | ||
≤10 mm | 26 (25.7) | 26 (51) | 14 (31.1) | 13 (68.4) | ||
Echogenicity | 0.527 | 0.271 | ||||
Iso/hyperechoic | 5 (5.0) | 1 (2.0) | 3 (6.7) | 2 (10.5) | ||
Hypoechoic | 37 (36.6) | 16 (31.4) | 18 (40) | 11 (57.9) | ||
Marked hypoechoic | 59 (58.4) | 34 (66.7) | 24 (53.3) | 6 (31.6) | ||
Aspect ratio > 1 | 0.690 | 0.531 | ||||
Absent | 62 (61.4) | 33 (64.7) | 32 (71.1) | 12 (63.2) | ||
Present | 39 (38.6) | 18 (35.3) | 13 (28.9) | 7 (36.8) | ||
Margin | 0.467 | 0.108 | ||||
Smooth | 4 (4.0) | 2 (3.9) | 3 (6.7) | 4 (21.1) | ||
Ill-defined | 11 (10.9) | 9 (17.6) | 5 (11.1) | 4 (21.1) | ||
Irregular | 86 (85.1) | 40 (78.4) | 37 (82.2) | 11 (57.9) | ||
Microcalcification | 0.355 | 0.739 | ||||
Absent | 31 (30.7) | 12 (23.5) | 10 (22.2) | 3 (15.8) | ||
Present | 70 (69.3) | 39 (76.5) | 35 (77.8) | 16 (84.2) | ||
Enhancement degree | 0.230 | 0.298 | ||||
Hyper-enhancement | 5 (5.0) | 2 (3.9) | 2 (4.4) | 1 (5.3) | ||
Iso-enhancement | 26 (25.7) | 7 (13.7) | 7 (15.6) | 6 (31.6) | ||
Hypo-enhancement | 70 (69.3) | 42 (82.4) | 36 (80) | 12 (63.2) | ||
BMUS-reported ETE | 0.019 | 0.038 | ||||
Negative | 60 (59.4) | 20 (39.2) | 27 (60.0) | 6 (31.6) | ||
Positive | 41 (40.6) | 31 (60.8) | 18 (40.0) | 13 (68.4) | ||
CEUS-reported ETE | <0.001 | 0.117 | ||||
Negative | 88 (87.1) | 22 (43.1) | 37 (82.2) | 12 (63.2) | ||
Positive | 13 (12.9) | 29 (56.9) | 8 (17.8) | 7 (36.8) | ||
BMUS Radscore | <0.001 | 0.004 | ||||
Median (interquartile range) | −1.11 (−1.31, −0.85) | −0.56 (−1.13, 0.05) | −0.97 (−1.31, −0.61) | −0.36 (−0.93, 0.45) | ||
CEUS Radscore | <0.001 | 0.003 | ||||
Median (interquartile range) | −1.28 (−2.00, −0.48) | −0.23 (−0.83, 0.52) | −0.97 (−1.79, −0.28) | −0.09 (−0.60, 0.21) |
Characteristics | Odds Ratio (95%CI) | p-Value |
---|---|---|
BMUS radiomics model | ||
original_ngtdm_Busyness | 2.58 (1.60, 4.15) | <0.001 |
CEUS radiomics model | ||
wavelet.LHL_glszm_SmallAreaEmphasis | 1.87 (1.14, 3.08) | 0.013 |
wavelet.HLL_gldm_DependenceVariance | 0.50 (0.31, 0.79) | 0.003 |
wavelet.HLL_ngtdm_Complexity | 1.70 (1.11, 2.61) | 0.015 |
Clinical model | ||
Age (≥55 years vs. <55 years) | 4.00 (1.52, 10.50) | 0.005 |
Tumor size (>10 mm vs. ≤10 mm) | 2.08 (0.90, 4.81) | 0.087 |
CEUS-reported ETE (positive vs. negative) | 7.42 (3.14, 17.56) | <0.001 |
Clinical-radiomics model | ||
Age (≥55 years vs. <55 years) | 3.89 (1.45, 10.49) | 0.007 |
CEUS-reported ETE (positive vs. negative) | 4.70 (1.84, 11.99) | 0.001 |
BMUS Radscore | 1.72 (0.98, 3.01) | 0.058 |
CEUS Radscore | 1.75 (1.09, 2.80) | 0.020 |
Group | Model | AUC (95% CI) | p Value (vs. Combined Model) | Sensitivity | Specificity | Cutoff Value |
---|---|---|---|---|---|---|
Training set | BMUS radiomics | 0.704 (0.610–0.799) | <0.001 | 0.627 | 0.782 | 0.305 |
CEUS radiomics | 0.768 (0.694–0.843) | 0.009 | 0.922 | 0.495 | 0.213 | |
Clinical | 0.793 (0.715–0.871) | 0.004 | 0.745 | 0.782 | 0.307 | |
Clinical-radiomics | 0.843 (0.773–0.913) | - | 0.765 | 0.832 | 0.356 | |
Validation set | BMUS radiomics | 0.731 (0.595–0.867) | 0.343 | 0.632 | 0.689 | 0.305 |
CEUS radiomics | 0.739 (0.617–0.861) | 0.419 | 0.947 | 0.333 | 0.213 | |
Clinical | 0.718 (0.588–0.847) | 0.044 | 0.526 | 0.711 | 0.307 | |
Clinical-radiomics | 0.792 (0.674–0.910) | - | 0.789 | 0.778 | 0.356 |
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Jiang, L.; Guo, S.; Zhao, Y.; Cheng, Z.; Zhong, X.; Zhou, P. Predicting Extrathyroidal Extension in Papillary Thyroid Carcinoma Using a Clinical-Radiomics Nomogram Based on B-Mode and Contrast-Enhanced Ultrasound. Diagnostics 2023, 13, 1734. https://doi.org/10.3390/diagnostics13101734
Jiang L, Guo S, Zhao Y, Cheng Z, Zhong X, Zhou P. Predicting Extrathyroidal Extension in Papillary Thyroid Carcinoma Using a Clinical-Radiomics Nomogram Based on B-Mode and Contrast-Enhanced Ultrasound. Diagnostics. 2023; 13(10):1734. https://doi.org/10.3390/diagnostics13101734
Chicago/Turabian StyleJiang, Liqing, Shiyan Guo, Yongfeng Zhao, Zhe Cheng, Xinyu Zhong, and Ping Zhou. 2023. "Predicting Extrathyroidal Extension in Papillary Thyroid Carcinoma Using a Clinical-Radiomics Nomogram Based on B-Mode and Contrast-Enhanced Ultrasound" Diagnostics 13, no. 10: 1734. https://doi.org/10.3390/diagnostics13101734