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.
Department of Ultrasonography, First Affiliated Hospital of Guangxi Medical University, 6 Shuangyong Road, Nanning, 530021, Guangxi Zhuang Autonomous Region, People's Republic of China.
BMC Surg. 2020 Dec 4;20(1):315. doi: 10.1186/s12893-020-00974-7.
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.
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.
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.
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.
淋巴结转移（LNM）是甲状腺癌患者治疗和预后的重要因素。本研究旨在探讨术前超声特征和放射组学分析在预测甲状腺癌患者 LNM 中的临床价值。
回顾性分析 150 个甲状腺结节的超声图像特征。所有结节均经病理证实为甲状腺癌。在评估的患者中，仅有 126 例患者进行了淋巴结清扫术。所有患者均在术前接受了超声检查。在放射组学分析中，使用 ITK-SNAP 软件从选定的超声图像中识别感兴趣区域。使用 Ultrosomics 软件提取放射组学特征。然后，将数据分为训练集和验证集。使用假设检验和装袋法构建模型。评估不同超声特征的诊断性能，进行放射组学分析，并进行受试者工作特征（ROC）曲线分析以探索诊断准确性。
在 LNM 的预测方面，ROC 曲线显示，不规则形状和微钙化的曲线下面积（AUC）值分别为 0.591（P=0.059）和 0.629（P=0.007）。在放射组学分析中，在训练集中，LNM 的 AUC 值为 0.759，灵敏度为 0.90，特异度为 0.860。在验证集中，AUC 为 0.803，灵敏度为 0.727，特异度为 0.800。
微钙化和不规则形状是甲状腺癌患者发生 LNM 的预测因子。此外，放射组学分析在筛选有意义的超声特征方面具有有前途的价值，对于甲状腺癌患者 LNM 的筛查具有重要意义。因此，基于超声特征和放射特征的 LNM 预测有助于在甲状腺癌手术前做出适当的手术和干预决策。
