Dual-modal radiomics nomogram based on contrast-enhanced ultrasound to improve differential diagnostic accuracy and reduce unnecessary biopsy rate in ACR TI-RADS 4–5 thyroid nodules
Abstract Background American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS, TR) 4 and 5 thyroid nodules (TNs) demonstrate much more complicated and overlapping risk characteristics than TR1-3 and have a rather wide range of malignancy possibilities (> 5%), which ma...
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | Cancer Imaging |
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| Online Access: | https://doi.org/10.1186/s40644-024-00661-3 |
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| author | Jia-Yu Ren Wen-Zhi Lv Liang Wang Wei Zhang Ying-Ying Ma Yong-Zhen Huang Yue-Xiang Peng Jian-Jun Lin Xin-Wu Cui |
| author_facet | Jia-Yu Ren Wen-Zhi Lv Liang Wang Wei Zhang Ying-Ying Ma Yong-Zhen Huang Yue-Xiang Peng Jian-Jun Lin Xin-Wu Cui |
| author_sort | Jia-Yu Ren |
| collection | DOAJ |
| description | Abstract Background American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS, TR) 4 and 5 thyroid nodules (TNs) demonstrate much more complicated and overlapping risk characteristics than TR1-3 and have a rather wide range of malignancy possibilities (> 5%), which may cause overdiagnosis or misdiagnosis. This study was designed to establish and validate a dual-modal ultrasound (US) radiomics nomogram integrating B-mode ultrasound (BMUS) and contrast-enhanced ultrasound (CEUS) imaging to improve differential diagnostic accuracy and reduce unnecessary fine needle aspiration biopsy (FNAB) rates in TR 4–5 TNs. Methods A retrospective dataset of 312 pathologically confirmed TR4-5 TNs from 269 patients was collected for our study. Data were randomly divided into a training dataset of 219 TNs and a validation dataset of 93 TNs. Radiomics characteristics were derived from the BMUS and CEUS images. After feature reduction, the BMUS and CEUS radiomics scores (Rad-score) were built. A multivariate logistic regression analysis was conducted incorporating both Rad-scores and clinical/US data, and a radiomics nomogram was subsequently developed. The performance of the radiomics nomogram was evaluated using calibration, discrimination, and clinical usefulness, and the unnecessary FNAB rate was also calculated. Results BMUS Rad-score, CEUS Rad-score, age, shape, margin, and enhancement direction were significant independent predictors associated with malignant TR4-5 TNs. The radiomics nomogram involving the six variables exhibited excellent calibration and discrimination in the training and validation cohorts, with an AUC of 0.873 (95% CI, 0.821–0.925) and 0.851 (95% CI, 0.764–0.938), respectively. The marked improvements in the net reclassification index and integrated discriminatory improvement suggested that the BMUS and CEUS Rad-scores could be valuable indicators for distinguishing benign from malignant TR4-5 TNs. Decision curve analysis demonstrated that our developed radiomics nomogram was an instrumental tool for clinical decision-making. Using the radiomics nomogram, the unnecessary FNAB rate decreased from 35.3 to 14.5% in the training cohort and from 41.5 to 17.7% in the validation cohorts compared with ACR TI-RADS. Conclusion The dual-modal US radiomics nomogram revealed superior discrimination accuracy and considerably decreased unnecessary FNAB rates in benign and malignant TR4-5 TNs. It could guide further examination or treatment options. |
| first_indexed | 2024-03-07T15:26:38Z |
| format | Article |
| id | doaj.art-4cf6540e9ff049d7a650e5d646f49392 |
| institution | Directory Open Access Journal |
| issn | 1470-7330 |
| language | English |
| last_indexed | 2024-03-07T15:26:38Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
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| series | Cancer Imaging |
| spelling | doaj.art-4cf6540e9ff049d7a650e5d646f493922024-03-05T16:41:07ZengBMCCancer Imaging1470-73302024-01-0124111610.1186/s40644-024-00661-3Dual-modal radiomics nomogram based on contrast-enhanced ultrasound to improve differential diagnostic accuracy and reduce unnecessary biopsy rate in ACR TI-RADS 4–5 thyroid nodulesJia-Yu Ren0Wen-Zhi Lv1Liang Wang2Wei Zhang3Ying-Ying Ma4Yong-Zhen Huang5Yue-Xiang Peng6Jian-Jun Lin7Xin-Wu Cui8Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Artificial Intelligence, Julei Technology CompanyCenter of Computer, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Medical Ultrasound, The First People’s Hospital of QinzhouDepartment of Medical Ultrasound, The First People’s Hospital of QinzhouDepartment of Medical Ultrasound, Wuhan Third Hospital, Tongren Hospital of Wuhan UniversityDepartment of Medical Ultrasound, The First People’s Hospital of QinzhouDepartment of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyAbstract Background American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS, TR) 4 and 5 thyroid nodules (TNs) demonstrate much more complicated and overlapping risk characteristics than TR1-3 and have a rather wide range of malignancy possibilities (> 5%), which may cause overdiagnosis or misdiagnosis. This study was designed to establish and validate a dual-modal ultrasound (US) radiomics nomogram integrating B-mode ultrasound (BMUS) and contrast-enhanced ultrasound (CEUS) imaging to improve differential diagnostic accuracy and reduce unnecessary fine needle aspiration biopsy (FNAB) rates in TR 4–5 TNs. Methods A retrospective dataset of 312 pathologically confirmed TR4-5 TNs from 269 patients was collected for our study. Data were randomly divided into a training dataset of 219 TNs and a validation dataset of 93 TNs. Radiomics characteristics were derived from the BMUS and CEUS images. After feature reduction, the BMUS and CEUS radiomics scores (Rad-score) were built. A multivariate logistic regression analysis was conducted incorporating both Rad-scores and clinical/US data, and a radiomics nomogram was subsequently developed. The performance of the radiomics nomogram was evaluated using calibration, discrimination, and clinical usefulness, and the unnecessary FNAB rate was also calculated. Results BMUS Rad-score, CEUS Rad-score, age, shape, margin, and enhancement direction were significant independent predictors associated with malignant TR4-5 TNs. The radiomics nomogram involving the six variables exhibited excellent calibration and discrimination in the training and validation cohorts, with an AUC of 0.873 (95% CI, 0.821–0.925) and 0.851 (95% CI, 0.764–0.938), respectively. The marked improvements in the net reclassification index and integrated discriminatory improvement suggested that the BMUS and CEUS Rad-scores could be valuable indicators for distinguishing benign from malignant TR4-5 TNs. Decision curve analysis demonstrated that our developed radiomics nomogram was an instrumental tool for clinical decision-making. Using the radiomics nomogram, the unnecessary FNAB rate decreased from 35.3 to 14.5% in the training cohort and from 41.5 to 17.7% in the validation cohorts compared with ACR TI-RADS. Conclusion The dual-modal US radiomics nomogram revealed superior discrimination accuracy and considerably decreased unnecessary FNAB rates in benign and malignant TR4-5 TNs. It could guide further examination or treatment options.https://doi.org/10.1186/s40644-024-00661-3ACR TI-RADS 4–5Thyroid nodulesContrast-enhanced ultrasoundRadiomicsNomogram |
| spellingShingle | Jia-Yu Ren Wen-Zhi Lv Liang Wang Wei Zhang Ying-Ying Ma Yong-Zhen Huang Yue-Xiang Peng Jian-Jun Lin Xin-Wu Cui Dual-modal radiomics nomogram based on contrast-enhanced ultrasound to improve differential diagnostic accuracy and reduce unnecessary biopsy rate in ACR TI-RADS 4–5 thyroid nodules Cancer Imaging ACR TI-RADS 4–5 Thyroid nodules Contrast-enhanced ultrasound Radiomics Nomogram |
| title | Dual-modal radiomics nomogram based on contrast-enhanced ultrasound to improve differential diagnostic accuracy and reduce unnecessary biopsy rate in ACR TI-RADS 4–5 thyroid nodules |
| title_full | Dual-modal radiomics nomogram based on contrast-enhanced ultrasound to improve differential diagnostic accuracy and reduce unnecessary biopsy rate in ACR TI-RADS 4–5 thyroid nodules |
| title_fullStr | Dual-modal radiomics nomogram based on contrast-enhanced ultrasound to improve differential diagnostic accuracy and reduce unnecessary biopsy rate in ACR TI-RADS 4–5 thyroid nodules |
| title_full_unstemmed | Dual-modal radiomics nomogram based on contrast-enhanced ultrasound to improve differential diagnostic accuracy and reduce unnecessary biopsy rate in ACR TI-RADS 4–5 thyroid nodules |
| title_short | Dual-modal radiomics nomogram based on contrast-enhanced ultrasound to improve differential diagnostic accuracy and reduce unnecessary biopsy rate in ACR TI-RADS 4–5 thyroid nodules |
| title_sort | dual modal radiomics nomogram based on contrast enhanced ultrasound to improve differential diagnostic accuracy and reduce unnecessary biopsy rate in acr ti rads 4 5 thyroid nodules |
| topic | ACR TI-RADS 4–5 Thyroid nodules Contrast-enhanced ultrasound Radiomics Nomogram |
| url | https://doi.org/10.1186/s40644-024-00661-3 |
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