The Value Of Diagnostic Nomogram Based On CT Radiomics For The Preoperative Differentiation Between Thyroid Papillary Carcinoma And Nodular Goiter

Objective: To explore the classification performance of nomogram constructed from CT signs combined with radiomics for papillary thyroid carcinoma(PTC)and nodular goiter(NG).Methods: The clinical data and CT images of patients with thyroid nodules confirmed by pathology in our hospital from January 2019 to April 2022 were analyzed retrospectively.CT plain scan and enhanced scan were performed within 2 weeks before operation;PTC113 cases,NG119 cases;The patients were divided into training cohort(162 cases)and test cohort(70 cases)at a ratio of 7∶3 using random stratified sampling.Relevant signs and iconography features of thyroid nodules were extracted from CT plain scan and two-phase enhanced images.Through screening of clinical image signs and iconography features,four independent models were constructed in the training set and the test set,and calculating the radscore.The combined model was constructed based on the radscore and the clinical model,and to draw the nomogram based on the combined model.The performance of models in the differential diagnosis of PTC and NG was evaluated by multiple indicators,such as receiver operating characteristic curve(ROC),area under the curve(AUC),net reclassification improvement(NRI),integrated discrimination improvement(IDI),and so on.Calibration plots were formulated to evaluate the reliability and accuracy of the nomograms,and the clinical value of nomograms were evaluated by using decision curves.Results:6,4 and 3 features were retained to construct plain‐scanned model,arterial-phase and venous-phase models respectively.In single phase,the plain-scanned model has the best differential diagnosis performance,six independent predictors were used to construct the clinical models,nomograms based on combined models had the highest differential diagnostic efficacy for PTC and NG(training set:AUC was 0.980;test set: AUC was 0.928).The Delong test showed that except for the clinical models in the test set,the differences of AUC values between the nomograms and other independent models were significant statistically(p<0.05),the nomogram of training set and test set has positive improvement compared with plain scan model and clinical model(NRI>0,IDI>0).The calibration curves showed that the predicted results of nomograms were in good agreement with the pathological results,and the decision curves showed that nomograms had the higher clinical value.Conclusion: The nomogram of CT signs combined with radiomics might be a potential method for distinguishing PTC and NG with good performance.