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Using ultrasound radiomics analysis to diagnose cervical lymph node metastasis in patients with nasopharyngeal carcinoma

  • Ultrasound
  • Published:
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Abstract

Objective

This study aimed to explore the clinical value of ultrasound radiomics analysis in the diagnosis of cervical lymph node metastasis (CLNM) in patients with nasopharyngeal carcinoma (NPC).

Methods

A total of 205 cases of NPC CLNM and 284 cases of benign lymphadenopathy with pathologic diagnosis were retrospectively included. Grayscale ultrasound (US) images of the largest section of every lymph node underwent feature extraction. Feature selection was done by maximum relevance minimum redundancy (mRMR) algorithm and multivariate logistic least absolute shrinkage and selection operator (LASSO) regression. Logistic regression models were developed based on clinical features, radiomics features, and the combination of those features. The AUCs of models were analyzed by DeLong’s test.

Results

In the clinical model, lymph nodes in the upper neck, larger long axis, and unclear hilus were significant factors for CLNM (p < 0.001). MRMR and LASSO regression selected 7 significant features for the radiomics model from the 386 radiomics features extracted. In the validation dataset, the AUC value was 0.838 (0.776–0.901) in the clinical model, 0.810 (0.739–0.881) in the radiomics model, and 0.880 (0.826–0.933) in the combined model. There was not a significant difference between the AUCs of clinical models and radiomics models in both datasets. DeLong’s test revealed a significantly larger AUC in the combined model than in the clinical model in both training (p = 0.049) and validation datasets (p = 0.027).

Conclusion

Ultrasound radiomics analysis has potential value in screening meaningful ultrasound features and improving the diagnostic efficiency of ultrasound in CLNM of patients with NPC.

Key Points

• Radiomics analysis of gray-scale ultrasound images can be used to develop an effective radiomics model for the diagnosis of cervical lymph node metastasis in nasopharyngeal carcinoma patients.

• Radiomics model combined with general ultrasound features performed better than the clinical model in differentiating cervical lymph node metastases from benign lymphadenopathy.

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Abbreviations

CEUS:

Contrast-enhanced ultrasound

CLN:

Cervical lymph node

CLNM:

Cervical lymph node metastasis

ENS:

Extranodal neoplastic spread

ICC:

Interclass correlation coefficient

LASSO:

Least absolute shrinkage and selection operator

mRMR:

Maximum relevance minimum redundancy

NPC:

Nasopharyngeal carcinoma

RLN:

Retropharyngeal lymph node

ROC:

Receiver operating characteristic

ROI:

Region of interest

SWE:

Shear wave elastography

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Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Ultrasound, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, No. 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, People’s Republic of China

    Min Lin, Xiaofeng Tang, Lan Cao, Ying Liao, Yafang Zhang & Jianhua Zhou

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  1. Min Lin
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  2. Xiaofeng Tang
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  3. Lan Cao
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  4. Ying Liao
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  5. Yafang Zhang
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  6. Jianhua Zhou
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Corresponding author

Correspondence to Jianhua Zhou.

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Guarantor

The scientific guarantor of this publication is Jianhua Zhou.

Conflicts of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the IRB for this retrospective study.

Ethical approval

This retrospective study was approved by the Institutional Review Board (IRB) of Sun Yat-sen University Cancer Center.

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• retrospective

• diagnostic study

• performed at one institution

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Lin, M., Tang, X., Cao, L. et al. Using ultrasound radiomics analysis to diagnose cervical lymph node metastasis in patients with nasopharyngeal carcinoma. Eur Radiol 33, 774–783 (2023). https://doi.org/10.1007/s00330-022-09122-6

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  • DOI: https://doi.org/10.1007/s00330-022-09122-6

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