Benefit of Using Both Ultrasound Imaging and Clinical Information for Predicting Malignant Soft Tissue Tumors

Objective: Ultrasonography (US) is the primary imaging method for soft tissue tumors (STTs), the diagnostic performance of which still requires improvement. To achieve an accurate evaluation of STTs, we built the diagnostic nomogram for STTs using the clinical and US features of patients with STTs.Methods: A total of 613 patients with 195 malignant and 418 benign STTs were retrospectively recruited. We used a blend of clinical and ultrasonic features, as well as exclusively US features, to develop two distinct diagnostic models for STTs: the clinical-US model and the US-only model, respectively. The two models were evaluated and compared by measuring their areas under the receiver operating characteristic curve (AUC), calibration, integrated discrimination improvement (IDI) and decision curve analysis. The performance of the clinical-US model was also compared with that of two radiologists.Results: The clinical-US model had better diagnostic performance than the model based on US imaging features alone (AUCs of the clinical-US and US-only models: 0.95 [0.93-0.97] vs. 0.89 [0.87-0.92], p < 0.001; IDI of the two models: 0.15 +/- 0.03, p < 0.001). The clinical-US model was also superior to the two radiologists in diagnosing STTs (AUCs of clinical-US model and two radiologists: 0.95 [0.93-0.97] vs. 0.79 [0.75-0.82] and 0.83 [0.80-0.85],p < 0.001).Conclusion: The diagnostic model based on clinical and US imaging features had high diagnostic performance in STTs, which could help identify malignant STTs for radiologists.