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.
Conclusions: 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.
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。
Keywords: central lymph node metastasis; papillary thyroid carcinoma; radiomics.