Nomogram based on spectral CT quantitative parameters and typical radiological features for distinguishing benign from malignant thyroid micro-nodules

被引:9
作者
Song, Zuhua [1 ]
Li, Qian [1 ]
Zhang, Dan [1 ]
Li, Xiaojiao [1 ]
Yu, Jiayi [1 ]
Liu, Qian [1 ]
Li, Zongwen [1 ]
Huang, Jie [1 ]
Zhang, Xiaodi [2 ]
Tang, Zhuoyue [1 ]
机构
[1] Chongqing Gen Hosp, Dept Radiol, 118 Xingguang Ave, Chongqing 401147, Peoples R China
[2] Philips Healthcare, Chengdu Branch, Chengdu, Peoples R China
关键词
Thyroid nodule; Spectral computed tomography; Nomogram; Diagnosis; Differential; CONTRAST-ENHANCED ULTRASOUND; COMPUTED-TOMOGRAPHY; CANCER; MICROCARCINOMAS; CLASSIFICATION; MANAGEMENT; DIAGNOSIS;
D O I
10.1186/s40644-023-00525-2
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
PurposeTo analyse the predictive effect of a nomogram combining dual-layer spectral computed tomography (DSCT) quantitative parameters with typical radiological features in distinguishing benign micro-nodule from thyroid microcarcinoma (TMC).MethodsData from 342 instances with thyroid micro-nodules (<= 1 cm) who underwent DSCT (benign group: n = 170; malignant group: n = 172) were reviewed. Typical radiological features including micro-calcification and enhanced blurring, and DSCT quantitative parameters including attenuation on virtual monoenergetic images (40 keV, 70 keV and 100 keV), the slope of the spectral HU curve (lambda HU), normalized iodine concentration (NIC), and normalized effective atomic number (NZeff) in the arterial phase (AP) and venous phase (VP), were measured and compared between the benign and malignant groups. The receiver operating characteristic (ROC) curve was used to assess the diagnostic performance of significant quantitative DSCT parameters or the models combining DSCT parameters respectively and typical radiological features based on multivariate logistic regression (LR) analysis. A nomogram was developed using predictors with the highest diagnostic performance in the above model, as determined by multivariate LR analysis.ResultsThe DSCT parameter AP lambda HU showed the greatest diagnostic efficiency in identifying patients with TMC, with an area under the ROC curve (AUC) of 0.829, a sensitivity and specificity of 0.738 and 0.753, respectively. Then, AP lambda HU was combined with the two radiological features to construct the DSCT-Radiological nomogram, which had an AUC of 0.858, a sensitivity of 0.791 and a specificity of 0.800. The calibration curve of the nomogram demonstrated that the prediction result was in good agreement with the actual observation. The decision curve revealed that the nomogram can result in a greater net benefit than the all/none-intervention strategy for all threshold probabilities.ConclusionAs a valid and visual noninvasive prediction tool, the DSCT-Radiological nomogram incorporating DSCT quantitative parameters and radiological features shows favourable predictive efficiency for identifying benign and malignant thyroid micro-nodules.
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页数:11
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共 25 条
  • [1] The Accuracy of Thyroid Nodule Ultrasound to Predict Thyroid Cancer: Systematic Review and Meta-Analysis
    Brito, Juan P.
    Gionfriddo, Michael R.
    Al Nofal, Alaa
    Boehmer, Kasey R.
    Leppin, Aaron L.
    Reading, Carl
    Callstrom, Matthew
    Elraiyah, Tarig A.
    Prokop, Larry J.
    Stan, Marius N.
    Murad, M. Hassan
    Morris, John C.
    Montori, Victor M.
    [J]. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2014, 99 (04) : 1253 - 1263
  • [2] Dideban Shiva, 2016, Iran J Pathol, V11, P1
  • [3] The Incidental Thyroid Nodule
    Fisher, Sarah B.
    Perrier, Nancy D.
    [J]. CA-A CANCER JOURNAL FOR CLINICIANS, 2018, 68 (02) : 97 - 105
  • [5] Identification of benign and malignant thyroid nodules by in vivo iodine concentration measurement using single-source dual energy CT: A retrospective diagnostic accuracy study
    Gao, Shun-Yu
    Zhang, Xiao-Yan
    Wei, Wei
    Li, Xiao-Ting
    Li, Yan-Ling
    Xu, Min
    Sun, Ying-Shi
    Zhang, Xiao-Peng
    [J]. MEDICINE, 2016, 95 (39)
  • [6] Value of computed tomography in determining the nature of papillary thyroid microcarcinomas: evaluation of the computed tomographic characteristics
    Han, Zhi-Jiang
    Shu, Yan-Yan
    Lai, Xu-Feng
    Chen, Wen-Hui
    [J]. CLINICAL IMAGING, 2013, 37 (04) : 664 - 668
  • [7] 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
    Haugen, Bryan R.
    Alexander, Erik K.
    Bible, Keith C.
    Doherty, Gerard M.
    Mandel, Susan J.
    Nikiforov, Yuri E.
    Pacini, Furio
    Randolph, Gregory W.
    Sawka, Anna M.
    Schlumberger, Martin
    Schuff, Kathryn G.
    Sherman, Steven I.
    Sosa, Julie Ann
    Steward, David L.
    Tuttle, R. Michael
    Wartofsky, Leonard
    [J]. THYROID, 2016, 26 (01) : 1 - 133
  • [8] HEDINGER C, 1989, CANCER-AM CANCER SOC, V63, P908, DOI 10.1002/1097-0142(19890301)63:5<908::AID-CNCR2820630520>3.0.CO
  • [9] 2-I
  • [10] Dual-source dual-energy computed tomography-derived quantitative parameters combined with machine learning for the differential diagnosis of benign and malignant thyroid nodules
    Jiang, Liling
    Liu, Daihong
    Long, Ling
    Chen, Jiao
    Lan, Xiaosong
    Zhang, Jiuquan
    [J]. QUANTITATIVE IMAGING IN MEDICINE AND SURGERY, 2022, 12 (02) : 967 - 978