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Nomograms based on preoperative multimodal ultrasound of papillary thyroid carcinoma for predicting central lymph node metastasis

  • Ultrasound
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European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To establish a nomogram for predicting central lymph node metastasis (CLNM) based on the preoperative clinical and multimodal ultrasound (US) features of papillary thyroid carcinoma (PTC) and cervical LNs.

Methods

Overall, 822 patients with PTC were included in this retrospective study. A thyroid tumor ultrasound model (TTUM) and thyroid tumor and cervical LN ultrasound model (TTCLNUM) were constructed as nomograms to predict the CLNM risk. Areas under the curve (AUCs) evaluated model performance. Calibration and decision curves were applied to assess the accuracy and clinical utility.

Results

For the TTUM training and test sets, the AUCs were 0.786 and 0.789 and bias-corrected AUCs were 0.786 and 0.831, respectively. For the TTCLNUM training and test sets, the AUCs were 0.806 and 0.804 and bias-corrected AUCs were 0.807 and 0.827, respectively. Calibration and decision curves for the TTCLNUM nomogram exhibited higher accuracy and clinical practicability. The AUCs were 0.746 and 0.719 and specificities were 0.942 and 0.905 for the training and test sets, respectively, when the US tumor size was ≤ 8.45 mm, while the AUCs were 0.737 and 0.824 and sensitivity were 0.905 and 0.880, respectively, when the US tumor size was > 8.45 mm.

Conclusion

The TTCLNUM nomogram exhibited better predictive performance, especially for the CLNM risk of different PTC tumor sizes. Thus, it serves as a useful clinical tool to supply valuable information for active surveillance and treatment decisions.

Key Points

• Our preoperative noninvasive and intuitive prediction method can improve the accuracy of central lymph node metastasis (CLNM) risk assessment and guide clinical treatment in line with current trends toward personalized treatments.

• Preoperative clinical and multimodal ultrasound features of primary papillary thyroid carcinoma (PTC) tumors and cervical LNs were directly used to build an accurate and easy-to-use nomogram for predicting CLNM.

• The thyroid tumor and cervical lymph node ultrasound model exhibited better performance for predicting the CLNM of different PTC tumor sizes. It may serve as a useful clinical tool to provide valuable information for active surveillance and treatment decisions.

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Abbreviations

CI:

Confidence interval

CLN:

Central lymph node

CLND:

Central lymph node dissection

CLNM:

Central lymph node metastasis

LLN:

Lateral lymph node

LLNM:

Lateral lymph node metastasis

OR:

Odds ratio

PTC:

Papillary thyroid carcinoma

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Acknowledgements

We would like to thank Editage (www.editage.cn) for English language editing.

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

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Authors and Affiliations

  1. Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, No. 246, Xuefu Road, Nan Gang District, Harbin, 150000, Heilongjiang Province, China

    Quan Dai, Dongmei Liu, Yi Tao, Shouqiang Li, Chen Zhao, Zhuo Wang, Yangyang Tao, Jiawei Tian & Xiaoping Leng

  2. Department of General Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China

    Chao Ding

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Correspondence to Xiaoping Leng.

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Dai, Q., Liu, D., Tao, Y. et al. Nomograms based on preoperative multimodal ultrasound of papillary thyroid carcinoma for predicting central lymph node metastasis. Eur Radiol 32, 4596–4608 (2022). https://doi.org/10.1007/s00330-022-08565-1

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