影像组学预测甲状腺乳头状癌中央区淋巴结转移

Radiomics for prediction of central lymph node metastasis in the neck in patients with thyroid papillary carcinoma

目的探讨影像组学方法提取甲状腺乳头状癌(PTC)的纹理特征以预判颈部中央区淋巴结转移的可能性。方法前瞻性收集本院接受甲状腺细针穿刺活检证实为PTC的189例患者,常规超声检查有无中央区淋巴结转移;然后基于其PTC的超声横切面、纵切面及双切面的纹理特征,利用随机森林方法对纹理特征进行筛选并建立预测模型,预测颈部中央区淋巴结是否发生转移,并以最终手术病理结果为金标准进行比对。结果189例患者中,术前甲状腺超声检查诊断颈部中央区淋巴结转移的准确率为35%,灵敏度为28.6%,特异度为55%。影像组学分析PTC的超声横切面/纵切面/双切面预测颈部中央区淋巴结转移的准确率为66.06%/68.12%/77.69%,灵敏度为53%/46%/40%,特异度为52%/53%/51%。结论结合PTC的超声横及纵双切面纹理特征,影像组学方法预测颈部中央区淋巴结转移的准确性较单切面高,且远高于常规超声检查的准确率。

Objective To explore the feasibility of radiomics for predicting lymph node metastasis in the central region of the neck in patients with thyroid papillary carcinoma (PTC).Methods A total of 189 patients with PTC confirmed by thyroid fine needle aspiration biopsy were prospectively enrolled in this study.The cross-sectional and longitudinal ultrasound images and the images of both sections were analyzed for predicting central lymph node metastasis using a radiomics approach with pathological results as the gold standard.Results In the 189 patients,the accuracy,sensitivity and specificity of preoperative thyroid ultrasonography for diagnosis of central lymph node metastasis was 69.39%,64% and 73%,respectively.Based on the ultrasound images of the cross-sections,longitudinal sections and both sections,the accuracy,sensitivity and specificity of radiomics for predicting central lymph node metastasis was 66.06%/68.12%/77.69%,53%/46%/40%,and 52%/53%/51%, respectively.Conclusion Radiomics with combined analysis of the ultrasound images on the cross-section and longitudinal section images achieves a higher accuracy for predicting central lymph node metastasis than analysis a single section,and its diagnostic accuracy is much higher than that of conventional ultrasound examination.