Radiomics signature for prediction of lateral lymph node metastasis in conventional papillary thyroid carcinoma

PLoS One. 2020 Jan 15;15(1):e0227315. doi: 10.1371/journal.pone.0227315. eCollection 2020.


Purpose: Preoperative neck ultrasound (US) for lateral cervical lymph nodes is recommended for all patients undergoing thyroidectomy for thyroid malignancy, but it is operator dependent. We aimed to develop a radiomics signature using US images of the primary tumor to preoperatively predict lateral lymph node metastasis (LNM) in patients with conventional papillary thyroid carcinoma (cPTC).

Methods: Four hundred consecutive cPTC patients from January 2004 to February 2006 were enrolled as the training cohort, and 368 consecutive cPTC patients from March 2006 to February 2007 served as the validation cohort. A radiomics signature, which consisted of 14 selected features, was generated by the least absolute shrinkage and selection operator (LASSO) regression model in the training cohort. The discriminating performance of the radiomics signature was assessed in the validation cohort with the area under the receiver operating characteristic curve (AUC).

Results: The radiomics signature was significantly associated with lateral cervical lymph node status (p < 0.001). The AUC of its performance in discriminating metastatic and non-metastatic lateral cervical lymph nodes was 0.710 (95% CI: 0.649-0.770) in the training cohort and was 0.621 (95% CI: 0.560-0.682) in the validation cohort.

Conclusions: The present study showed that US radiomic features of the primary tumor were associated with lateral cervical lymph node status. Although their discriminatory performance was slightly lower in the validation cohort, our study shows that US radiomic features of the primary tumor alone have the potential to predict lateral LNM.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • Humans
  • Lymph Nodes / pathology
  • Lymph Nodes / radiation effects*
  • Lymph Nodes / surgery
  • Lymphatic Metastasis
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neck / pathology
  • Neck / radiation effects
  • Neck / surgery
  • Nomograms
  • ROC Curve
  • Thyroid Cancer, Papillary / diagnostic imaging
  • Thyroid Cancer, Papillary / pathology
  • Thyroid Cancer, Papillary / radiotherapy*
  • Thyroid Cancer, Papillary / surgery
  • Thyroidectomy
  • Ultrasonic Therapy / methods*
  • Ultrasonic Waves*

Grant support

This study was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) by the Ministry of Education (2016R1D1A1B03930375) and by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (2019R1A2C1002375). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.