Radiomics For Prediction Of Lymph Node Metastasis In The Central Region Of The Thyroid Papillary Carcinoma

Purposes:Patients with papillary thyroid carcinoma(PTC)have a higher probability of lymph node metastasis in the central region of the neck.Preoperative accurate prediction of lymph node metastasis in the central region of the neck can reduce unnecessary preventive central node lymph node dissection in thyroid papillary carcinoma Surgery to reduce postoperative complications.Conventional ultrasound has a low detection rate of lymph nodes in the central region of the neck.This study explored the possibility of predicting lymph node metastasis in the central region by analyzing the ultrasound signs of PTC through imaging histology.Methods:Collect clinical data of patients undergoing thyroid cancer surgery at Southern Hospital of Southern Medical University from March 2018 to February 2019.The inclusion criteria of the research objects were:single lesion,no anticancer treatment before surgery,pathological diagnosis of PTC,and thyroid ultrasound examination by two senior ultrasound specialists in our hospital before surgery.Exclusion criteria were:multiple lesions,received anti-cancer treatment before surgery,pathologically diagnosed as non-PTC,and did not undergo thyroid ultrasound examination in our hospital before surgery.A total of 189 cases were included in the study.Thyroid ultrasound examination uses Toshiba Aplio 500 color Doppler ultrasound diagnostic apparatus,7.5-12MHz linear array high-frequency probe.Two senior veterinary ultrasound doctors evaluated the results of thyroid ultrasound examination.The assessment contents included:the location,size(including 3 diameters),morphology,boundary,edge,internal echo,rear echo,calcification type and blood Current situation.The criteria for ultrasound diagnosis of lymph node metastasis in the central area are[1]:hyperechoic,microcalcification,disappearance of lymphatic portal,aspect ratio>0.5,cystic changes and internal and peripheral blood flow.A senior ultrasound doctor manually outlined the edges of the thyroid lesions,analyzed the collected ultrasound images of the lesions using imaging histology,and extracted a variety of advanced features through computer high-throughput,including gray-scale co-occurrence matrix and gray-scale run-length matrix,The characteristics of the gray level area matrix and the local gray difference matrix.The random forest algorithm is used to select features,and finally the representative high-level features are selected.The omics features selected by the random forest algorithm are used to build a prediction model in R language,and the prediction model is verified by the five-fold cross-validation method.Result:Among the 189 patients,the accuracy of preoperative thyroid ultrasound in diagnosing lymph node metastasis in the central region of the neck was 37%(70/189),sensitivity was 28.6%(37/129),and specificity was 55%(33/60).Through imaging histology,manual outline image analysis based on PTC ultrasound cross-sectional images and predict whether lymph nodes in the central neck area have metastasized,19 advanced features were screened out,and the area under the curve(AUC)was calculated to be 0.661 with an accuracy rate of 48%,The sensitivity is 53%,and the specificity is 52%.Based on the manual outline analysis and prediction of PTC ultrasound longitudinal section images,five advanced features were screened out.The AUC was calculated to be 0.681,the accuracy rate was 48%,the sensitivity was 46%,and the specificity was 53%;combined with PTC ultrasound cross section According to the analy sis and prediction of the manual outline diagram of the longitudinal section,16 advanced features are finally selected,and the calculated AUC is 0.777,the accuracy rate is 54%,the sensitivity is 40%,and the specificity is 51%.Conclusion:According to PTC’s ultrasound cross-sectional images and longitudinal cross-sectional images,the accuracy of image histology analysis and prediction of lymph node metastasis in the central region of the neck is higher than that of single-section images,and is much higher than the accuracy of conventional ultrasound diagnosis.Imaging omics improves the ability of preoperative ultrasound to predict lymph node metastasis in the central region of the neck of PTC,which is beneficial for surgeons to selectively perform lymph node dissection on patients,and greatly improves postoperative recovery and quality of life in patients with PTC benefit.