南方医科大学学报

南方医科大学学报 ›› 2019, Vol. 39 ›› Issue (09): 1094-.doi: 10.12122/j.issn.1673-4254.2019.09.15

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影像组学预测甲状腺乳头状癌中央区淋巴结转移

王伟镇，李颖嘉   

  • 出版日期:2019-09-20 发布日期:2019-09-20

Radiomics for prediction of central lymph node metastasis in the neck in patients with thyroid papillary carcinoma

  • Online:2019-09-20 Published:2019-09-20

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摘要： 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。

Abstract: 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. Conclusion 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.