ISSN 1004-4140
CN 11-3017/P
| Citation: |
WANG R, JIN D, XU L, et al. The Value of Radiomics Based on Spectral CT Iodine Map for Diagnosing Cervical Lymph Node Metastasis in Papillary Thyroid Carcinoma[J]. CT Theory and Applications, 2024, 33(3): 333-342. DOI: 10.15953/j.ctta.2022.242. (in Chinese).
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Objective: To investigate the value of radiomics features based on spectral CT iodine map for diagnosing metastatic cervical lymph nodes in patients with papillary thyroid carcinoma. Methods: Seventy-eight patients with papillary thyroid carcinoma who underwent cervical energy spectrum CT within two weeks before surgery were retrospectively analyzed. We included 117 metastatic, 176 non-metastatic lymph nodes, which were then randomly divided into a training set and a validation set in a 3:1 ratio. Radiomics features were extracted and screened from venous phase iodine maps. Logistic regression model was used to construct diagnostic models based on CT image features, radiomics signature, and a combination of the two, respectively; a nomogram was then drawn to visualize the combined model. The diagnostic performance, calibration ability and clinical practicability of each model were evaluated by ROC curve, calibration curve and decision curve analysis, respectively. Results: The combined model showed optimal diagnostic performance in both the training and validation sets, followed by radiomics model. These two models outperformed the CT image features model in both the training and validation sets. All models showed good calibration, and decision curve analysis demonstrated the superiority of the nomogram over the other two models in terms of clinical usefulness. Conclusion: The radiomics signature of spectral CT showed good performance in diagnosing lymph node metastasis of papillary thyroid carcinoma. The diagnostic performance was further improved when combined with CT image features, which can be a useful tool to assist in clinical decision-making.
| [1] |
MCLEOD D S, SAWKA A M, COOPER D S. Controversies in primary treatment of low-risk papillary thyroid cancer[J]. Lancet, 2013, 381(9871): 1046−1057. DOI: 10.1016/S0140-6736(12)62205-3.
|
| [2] |
PARK J H, YOON J H. Lobectomy in patients with differentiated thyroid cancer: Indications and follow-up[J]. Endocrine-Related Cancer, 2019, 26(7): R381−R393. DOI: 10.1530/ERC-19-0085.
|
| [3] |
CHOI J S, KIM J, KWAK J Y, et al. Preoperative staging of papillary thyroid carcinoma: Comparison of ultrasound imaging and CT[J]. American Journal of Roentgenology, 2009, 193(3): 871−878. DOI: 10.2214/AJR.09.2386.
|
| [4] |
ROH J L, PARK J Y, KIM J M, et al. Use of preoperative ultrasonography as guidance for neck dissection in patients with papillary thyroid carcinoma[J]. Journal of Surgical Oncology, 2009, 99(1): 28−31. DOI: 10.1002/jso.21164.
|
| [5] |
KIM E, PARK J S, SON K R, et al. Preoperative diagnosis of cervical metastatic lymph nodes in papillary thyroid carcinoma: Comparison of ultrasound, computed tomography, and combined ultrasound with computed tomography[J]. Thyroid, 2008, 18(4): 411−418. DOI: 10.1089/thy.2007.0269.
|
| [6] |
LAMBIN P, LEIJENAAR R T, DEIST T M, et al. Radiomics: The bridge between medical imaging and personalized medicine[J]. Nature Reviews Clinical Oncology, 2017, 14(12): 749−762. DOI: 10.1038/nrclinonc.2017.141.
|
| [7] |
GILLIES R J, KINAHAN P E, HRICAK H. Radiomics: Images are more than pictures, they are data[J]. Radiology, 2016, 278(2): 563−577. DOI: 10.1148/radiol.2015151169.
|
| [8] |
ZHOU Y, SU G Y, HU H, et al. Radiomics analysis of dual-energy CT-derived iodine maps for diagnosing metastatic cervical lymph nodes in patients with papillary thyroid cancer[J]. European Radiology, 2020, 30(11): 6251−6262. DOI: 10.1007/s00330-020-06866-x.
|
| [9] |
SCOTT G C, MEIER D A, DICKINSON C Z. Cervical lymph node metastasis of thyroid papillary carcinoma imaged with fluorine-18-FDG, technetium-99m-pertechnetate and iodine-131-sodium iodide[J]. Journal of Nuclear Medicine, 1995, 36(10): 1843−1845.
|
| [10] |
CHOI B, KIM D H, SON S H, et al. Usefulness of SPECT/CT for equivocal findings on I-131 whole-body scan in a patient with differentiated papillary thyroid cancer[J]. Clinical Nuclear Medicine, 2014, 39(2): E160−E2. DOI: 10.1097/RLU.0b013e318286b9bb.
|
| [11] |
中国医师协会外科医师分会甲状腺外科医师委员会, 中国研究型医院学会甲状腺疾病专业委员会. 分化型甲状腺癌颈侧区淋巴结清扫专家共识(2017版)[J]. 中国实用外科杂志, 2017, 37(9): 985−991. DOI: 10.19538/j.cjps.issn1005-2208.2017.09.13.
|
| [12] |
PARK J E, LEE J H, RYU K H, et al. Improved diagnostic accuracy using arterial phase CT for lateral cervical lymph node metastasis from papillary thyroid cancer[J]. American Journal of Neuroradiology, 2017, 38(4): 782−788. DOI: 10.3174/ajnr.A5054.
|
| [13] |
许晓泉, 周燕, 苏国义, 等. 联合CT图像特征和双能CT定量参数对甲状腺乳头状癌颈部淋巴结转移的诊断价值[J]. 中华放射学杂志, 2021, 55(2): 137−142. DOI: 10.3760/cma.j.cn112149-20200222-00226.
XU X Q, ZHOU Y, SU G Y, et al. Integrating CT image features and quantitative dual-energy CT parameters for diagnosing metastatic lymph nodes from papillary thyroid carcinoma[J]. Chinese Journal of Radiology, 2021, 55(2): 137−142. DOI: 10.3760/cma.j.cn112149-20200222-00226. (in Chinese).
|
| [14] |
中华医学会放射学分会头颈学组. 甲状腺结节影像检查流程专家共识[J]. 中华放射学杂志, 2016, 50(12): 911−915. DOI: 10.3760/cma.j.issn.1005-1201.2016.12.003.
|
| [15] |
魏培英, 蒋念东, 韩志江, 等. CT强化程度对甲状腺乳头状癌颈部淋巴结转移的诊断价值[J]. 中华内分泌外科杂志, 2020, 14(2): 144−148.
WEI P Y, JIANG N D, HAN Z J, et al. Value of CT enhancement degree in diagnosing cervical lymph node metastasis of papillary thyroid carcinoma[J]. Chinese Journal of Endocrine Surgery, 2020, 14(2): 144−148. (in Chinese).
|
| [16] |
KING A D, TSE G M, YUEN E H. et al. Comparison of CT and MR imaging for the detection of extranodal neoplastic spread in metastatic neck nodes[J]. European Journal of Radiology, 2004, 52(3): 264−270. DOI: 10.1016/j.ejrad.2004.03.004.
|
| [17] |
CHAI R L, RATH T J, JOHNSON J T, et al. Accuracy of computed tomography in the prediction of extracapsular spread of lymph node metastases in squamous cell carcinoma of the head and neck[J]. Jama Otolaryngology-Head & Neck Surgery, 2013, 139(11): 1187−1194.
|
| [18] |
HUGHES D T, HAYMART M R, MILLER B S, et al. The most commonly occurring papillary thyroid cancer in the united states is now a microcarcinoma in a patient older than 45 years[J]. Thyroid, 2011, 21(3): 231−236. DOI: 10.1089/thy.2010.0137.
|
| [19] |
WANG T S, DUBNER S, SZNYTER L A, et al. Incidence of metastatic well-differentiated thyroid cancer in cervical lymph nodes[J]. Archives of Otolaryngology-Head & Neck Surgery, 2004, 130(1): 110−113.
|
| [20] |
陈雨桐, 王燕. 超声诊断甲状腺乳头状癌颈部转移淋巴结的研究进展[J]. 肿瘤影像学, 2022, 31(2): 203−207.
CHEN Y T, WANG Y. Advances in ultrasonographic diagnosis of cervical lymph node metastasis in papillary carcinoma of the thyroid[J]. Oncoradiology, 2022, 31(2): 203−207. (in Chinese).
|
| [21] |
HAUGEN B R, ALEXANDER E K, BIBLE K C, et al. 2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer the American thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer[J]. Thyroid, 2016, 26(1): 1−133. DOI: 10.1089/thy.2015.0020.
|
| [22] |
LIU Z M, XUN X Q, WANG Y Z, et al. MRI and ultrasonography detection of cervical lymph node metastases in differentiated thyroid carcinoma before reoperation[J]. American Journal of Translational Research, 2014, 6(2): 147−154.
|
| [23] |
周燕, 许晓泉, 苏国义, 等. 双能CT动静脉期加权融合图像影像组学对甲状腺乳头状癌颈部淋巴结转移的诊断价值[J]. 中华放射学杂志, 2021, 55(7): 703−709.
ZHOU Y, XU X Q, SU G Y, et al. Radiomics based on arterial-venous mixed images derived from dual-energy CT data in diagnosis of lymph nodes metastasis of papillary thyroid cancer[J]. Chinese Journal of Radiology, 2021, 55(7): 703−709. (in Chinese).
|
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