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Chen Z, Zhan W, Wu Z, He H, Wang S, Huang X, Xu Z, Yang Y. The ultrasound-based radiomics-clinical machine learning model to predict papillary thyroid microcarcinoma in TI-RADS 3 nodules. Transl Cancer Res 2024; 13:278-289. [PMID: 38410213 PMCID: PMC10894343 DOI: 10.21037/tcr-23-1375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/17/2023] [Indexed: 02/28/2024]
Abstract
Background Conventional ultrasound (CUS) technology has proven to be successful in the identification of thyroid nodules. Moreover, the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) was developed for the purpose of evaluating the risk of thyroid nodules based on ultrasound imaging. Nevertheless, identifying papillary thyroid microcarcinoma (PTMC) from TI-RADS 3 nodules using this system can be difficult due to overlapping morphological features. The main objective of this study was to investigate the efficacy of a machine learning model that utilizes ultrasound-based radiomics features and clinical information in accurately predicting the presence of PTMC in TI-RADS 3 nodules. Methods A total of 221 patients with TI-RADS 3 nodules were included, consisting of 91 cases of PTMC and 130 benign thyroid nodules. They were randomly divided into training and test cohort in an 8:2 ratio. Radiomics features were extracted from CUS images by manually outlining the targets, while clinical parameters were obtained from electronic medical records. The radiomics model, clinical model, and combined model were constructed and validated to distinguish between PTMC and benign thyroid nodules. Radiomics variables were extracted via the Pyradiomics package (V1.3.0). Moreover, least absolute shrinkage and selection operator (LASSO) regression was used for feature selection. Light Gradient Boosting Machine (LightGBM) was employed to build both radiomics and clinical models. Ultimately, a radiomics-clinical model, which fused radiomics features with clinical information, was developed. Results Among a total of 1,477 radiomics features, fifteen features that were found to be associated with PTMC through univariate analysis and LASSO regression were selected for the development of the radiomics model. The combined "radiomics-clinical" model demonstrated superior diagnostic accuracy compared to the clinical model for distinguishing PTMC in both the training dataset [area under receiver operating curve (AUC): 0.975 vs. 0.845] and the validation dataset (AUC: 0.898 vs. 0.811). We constructed a radiomics-clinical nomogram, and the clinical applicability was confirmed through decision curve analysis. Conclusions Utilizing an ultrasound-based radiomics approach has proven to be effective in predicting PTMC in patients with TI-RADS 3 nodules.
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Affiliation(s)
- Zhang Chen
- Department of Ultrasound Imaging, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
| | - Wenting Zhan
- Department of Ultrasound Imaging, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zhijing Wu
- Department of Physics, University of Cambridge, Cambridge, UK
| | - Huiliao He
- Department of Ultrasound Imaging, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
| | - Shaoyi Wang
- Department of Ultrasound Imaging, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiaoyan Huang
- Department of Ultrasound Imaging, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zhihua Xu
- Department of Ultrasound Imaging, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yan Yang
- Department of Ultrasound Imaging, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
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Correlation between Ultrasonographic Appearance of Papillary Thyroid Microcarcinoma and BRAF V600E Mutation. JOURNAL OF ONCOLOGY 2022; 2022:5916379. [PMID: 35356255 PMCID: PMC8959952 DOI: 10.1155/2022/5916379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 02/07/2022] [Indexed: 11/22/2022]
Abstract
The study was conducted to investigate the correlation between the ultrasonographic appearance of a thyroid nodule and the BRAF V600E mutation. Patients with thyroid nodules (n = 186), for which BRAF V600E testing and cytopathology analysis were performed, and who underwent subsequent surgery for nodule resection were enrolled in this study. For each patient, color Doppler ultrasonography was performed to observe the variables of the nodules. The nodules were then characterized using the thyroid imaging reporting and data system classification TI-RADS. Furthermore, the ultrasonographic appearance of the control group, encompassing patients with nodular thyroid goiters, and the case group, encompassing patients with papillary thyroid microcarcinoma (PTMC), was statically analyzed. Similarly, a statistical analysis of the ultrasonographic appearance of the BRAF V600E-positive and BRAF V600E-negative subgroups was also performed. The accuracy was significantly different for the corresponding values when color Doppler ultrasonography, BRAF V600E testing, or cytopathology alone was used for diagnosis. There were significant differences in the ultrasonographic appearance variables between the control and case groups. Comparing with the BRAF V600E-negative subgroup of the case group, the ultrasonographic appearances of the BRAF V600E-positive subgroup showed less circumscribed and more irregularly shaped nodules, with significantly different aspect ratios of >1. The combination of BRAF V600E testing and color Doppler ultrasonography or cytopathology improved the accuracy of the PTMC diagnose. We found that the ultrasonographic appearance of thyroid nodules was related to PTMC.
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Chen K, Wang Z, Sun W, Zhang D, Zhang T, He L, Zhang H. Bibliometric insights in advances of papillary thyroid microcarcinoma: Research situation, hot points, and global trends. Front Endocrinol (Lausanne) 2022; 13:949993. [PMID: 36004350 PMCID: PMC9393698 DOI: 10.3389/fendo.2022.949993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 07/11/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Thyroid cancer has been on the rise over the last decade. Papillary thyroid microcarcinoma (PTMC) accounts for more than half of all thyroid cancers. Micropapillary carcinoma of the thyroid is a common but non-fatal form of thyroid cancer. To better comprehend, nearly two decades of scientific outputs were analyzed and summarized using bibliometric methods in this study. METHODS Approximately 1098 publications from 2000 and 2021 were included in WoS database through systematic retrieval. The general information was characterized, and developmental skeleton and research frontiers were explored. CiteSpace, VOSviewer, and R, Tableau were used to evaluate and visualize the results. RESULTS A total of 1098 publications from across 75 countries were identified. The annual number of publications showed an increasing trend in the past 21 years. China, Korea, the United States of America (USA), Italy, and Japan made remarkable contributions to the research of PTMC. Thyroid was the most productive journal. Miyauchi Akira published maximum articles. The utmost productive institution was the University of Ulsan. Risk stratification, active surveillance, and thermal ablation garnered the attention of researchers leading to novel approaches in the clinical diagnosis and treatment of micropapillary thyroid carcinoma. CONCLUSIONS This bibliometric study provides a comprehensive analysis of global productivity, collaboration, and research hotspots within PTMC field, which will aid in directing research toward PTMC in the coming years.
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Affiliation(s)
- Kefan Chen
- Department of Thyroid Surgery, the First Hospital of China Medical University, Shenyang, China
| | - Zhongqing Wang
- Department of Information center, the First Hospital of China Medical University, Shenyang, China
| | - Wei Sun
- Department of Thyroid Surgery, the First Hospital of China Medical University, Shenyang, China
| | - Dalin Zhang
- Department of Thyroid Surgery, the First Hospital of China Medical University, Shenyang, China
| | - Ting Zhang
- Department of Thyroid Surgery, the First Hospital of China Medical University, Shenyang, China
| | - Liang He
- Department of Thyroid Surgery, the First Hospital of China Medical University, Shenyang, China
| | - Hao Zhang
- Department of Thyroid Surgery, the First Hospital of China Medical University, Shenyang, China
- *Correspondence: Hao Zhang,
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Huang K, Bai Z, Bian D, Yang P, Li X, Liu Y. Diagnostic Accuracy of Contrast-Enhanced Ultrasonography in Papillary Thyroid Microcarcinoma Stratified by Size. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:269-274. [PMID: 31703968 DOI: 10.1016/j.ultrasmedbio.2019.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 09/25/2019] [Accepted: 10/01/2019] [Indexed: 06/10/2023]
Abstract
We explored the diagnostic accuracy of ultrasonography (US) in papillary thyroid microcarcinoma (PTMC), studying nodular growths according to size via 3-D color Doppler US (3-DCDUS) and contrast-enhanced US (CEUS). A total of 109 patients undergoing CEUS and surgery of thyroid nodules at the First Hospital of China Medical University between January 2017 and December 2018 were selected for the study, including 77 with post-operative pathologically confirmed PTMC (test group) and 32 with nodular goiter (controls). All nodules were ≤1.0 cm in maximum diameter. After 3-DCDUS, each patient underwent Thyroid Imaging Reporting and Data System (TI-RADS) grading. In both groups, receiver operating characteristic curve analysis of anteroposterior (AP) nodule diameters was conducted, establishing a cutpoint for probable malignancy by CEUS. In the test group (n = 77), grading was as follows: TI-RADS 4a, 23; TI-RADS 4b, 40; TI-RADS 4c, 14. More patients had heterogeneous enhancement or hypo-enhancement (n = 55) than uniform hyper-enhancement or uniform iso-enhancement (n = 22) by contrast-enhanced ultrasonography (CEUS). Control group (n = 32) grading was as follows: TI-RADS 3, 1; TI-RADS 4, 21; TI-RADS 4b, 10. Fewer patients had heterogeneous enhancement or hypo-enhancement (n = 12) than uniform hyper-enhancement or uniform iso-enhancement (n = 20) by CEUS. The diagnostic accuracy of 3-DCDUS or CEUS differed significantly from that of 3-DCD-US + CEUS (p < 0.05), whereas 3-DCDUS and CEUS performed similarly (p > 0.05). At AP diameters of 0.66 cm, the Youden index for diagnosing malignancy by CEUS was maximal. When nodules below this threshold were excluded, both CEUS and 3-DCDUS + CEUS improved significantly in diagnostic accuracy (p < 0.05). CEUS is useful in determining the status (benign vs. malignant) of thyroid nodules, with significantly better accuracy at AP diameters ≥0.66 cm.
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Affiliation(s)
- Kun Huang
- Department of Ultrasonic Diagnosis, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Zhiqun Bai
- Department of Ultrasonic Diagnosis, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Donglin Bian
- Department of Ultrasonic Diagnosis, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Puxu Yang
- Department of Ultrasonic Diagnosis, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xiangyi Li
- Department of Ultrasonic Diagnosis, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yanjun Liu
- Department of Ultrasonic Diagnosis, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China.
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Kaliszewski K, Zubkiewicz-Kucharska A, Kiełb P, Maksymowicz J, Krawczyk A, Krawiec O. Comparison of the prevalence of incidental and non-incidental papillary thyroid microcarcinoma during 2008-2016: a single-center experience. World J Surg Oncol 2018; 16:202. [PMID: 30305094 PMCID: PMC6180613 DOI: 10.1186/s12957-018-1501-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 09/28/2018] [Indexed: 03/19/2023] Open
Abstract
Background The incidence of papillary thyroid microcarcinoma (PTMC) is increasing; however, it is not clear whether this reflects an increase in the incidence of incidental or in that of non-incidentally (presurgically) discovered PTMC (IPTMC vs. NIPTMC). We assessed the incidence of IPTMC and NIPTMC over the past 9 years, to discern whether the increase in PTMC incidence is due to improved diagnostics or to a real increase in the incidence. Methods We performed a retrospective chart review of 4327 patients who were consecutively admitted to and surgically treated for thyroid pathology at a single institution. As a main presurgical diagnostic test, all patients underwent ultrasound-guided fine-needle aspiration biopsy (UG-FNAB). The analyzed time frame was divided into three equal periods (I: 2008–2010, II: 2011–2013, III: 2014–2016), and IPTMCs and NIPTMCs were assessed and compared in each period. Results We evaluated 393 (9.08%) patients with thyroid malignancy, of which 156 (3.60% of all thyroid tumors [TTs]; 39.69% of all thyroid cancers [TCs]) were diagnosed as PTMC. The prevalence of NIPTMC among all TCs increased from 16.66% in 2008 to 33.75% in 2016, while that of IPTMC decreased from 20.83% in 2008 to 13.75% in 2016. The incidence rates of NIPTMC and IPTMC in period III differed statistically significantly (p < 0.0001). The prevalence rate of NIPTMC in period III was higher than that in period II, yet comparable to that in period I (p = 0.0014; p = 0.2804, respectively). Conclusions The prevalence of NIPTMC, rather than that of IPTMC, is escalating; this may be due to better presurgical diagnosis.
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Affiliation(s)
- Krzysztof Kaliszewski
- First Department and Clinic of General, Gastroenterological, and Endocrine Surgery, Wroclaw Medical University, 66 Maria Skłodowska-Curie Street, 50-369, Wrocaw, Poland.
| | | | - Paweł Kiełb
- First Department and Clinic of General, Gastroenterological, and Endocrine Surgery, Wroclaw Medical University, 66 Maria Skłodowska-Curie Street, 50-369, Wrocaw, Poland
| | - Jerzy Maksymowicz
- First Department and Clinic of General, Gastroenterological, and Endocrine Surgery, Wroclaw Medical University, 66 Maria Skłodowska-Curie Street, 50-369, Wrocaw, Poland
| | - Aleksander Krawczyk
- First Department and Clinic of General, Gastroenterological, and Endocrine Surgery, Wroclaw Medical University, 66 Maria Skłodowska-Curie Street, 50-369, Wrocaw, Poland
| | - Otto Krawiec
- First Department and Clinic of General, Gastroenterological, and Endocrine Surgery, Wroclaw Medical University, 66 Maria Skłodowska-Curie Street, 50-369, Wrocaw, Poland
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Zhu Y, Deng S, Zhang Y, Jiang Q. Comparative study of ultrasonic elastography and conventional ultrasound in diagnosis of malignant anus neoplasm. Exp Ther Med 2018; 15:2343-2346. [PMID: 29456640 PMCID: PMC5795467 DOI: 10.3892/etm.2018.5720] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 12/12/2017] [Indexed: 12/26/2022] Open
Abstract
The application value of conventional ultrasound and ultrasonic elastography (UE) in preoperative diagnosis and combined diagnosis of malignant anus neoplasms was investigated. One hundred and twenty patients, whose mass was detected by digital rectal examination, were examined using UE and conventional ultrasound before operation, and the results were compared with those of histopathological examinations after operation, so that the accuracy and imaging features of UE as well as UE combined with conventional ultrasound in diagnosing malignant anus neoplasm were analyzed. Among the 120 patients, 77 were diagnosed with benign lesions and 43 were diagnosed with malignant lesions via pathological diagnosis for anal canal lesion surgery. Conventional ultrasound before operation showed that 53 patients were diagnosed with benign lesions and 26 with malignant lesions. Compared with that in the pathological diagnosis results, the diagnostic accordance rate in preoperative conventional ultrasound was 65.8%. Through UE diagnosis, 66 patients had benign lesions and 39 patients had malignant lesions. Compared with that in the pathological diagnosis results, the diagnostic accordance rate in preoperative UE was 87.5%. After the examination via UE combined with conventional ultrasound before operation, 71 patients were diagnosed with benign lesions and 40 patients were diagnosed with malignant lesions; compared with that in the pathological diagnosis results, the diagnostic accordance rate was 92.5%. In terms of mass qualitative diagnosis, the sensitivity and specificity of conventional ultrasound were 60.5 and 68.8%, respectively; those of UE were 90.7 and 85.7%, respectively, and those of UE combined with conventional ultrasound were 93.0 and 92.2%, respectively. According to the analysis results of receiver operating characteristic (ROC) curve, the area under curve (AUC) of malignant anus neoplasm diagnosed via UE was 0.732 [95% confidence interval (95% CI), 0.211-2.534], the AUC via conventional ultrasound was 0.695 (95% CI, 0.517-0.932), and that via UE combined with conventional ultrasound was 0.823 (95% CI, 0.146-4.643). In conclusion, examinations utilizing UE combined with conventional ultrasound can increase the preoperative diagnostic accordance rate in malignant anus neoplasm, which can be used as an effective method for preoperative diagnosis of malignant anus neoplasm.
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Affiliation(s)
- Yicheng Zhu
- Department of Ultrasound, Shanghai Pudong New Area People's Hospital, Shanghai 201299, P.R. China
| | - Shuhao Deng
- Department of Ultrasound, Shanghai Pudong New Area People's Hospital, Shanghai 201299, P.R. China
| | - Yuan Zhang
- Department of Ultrasound, Shanghai Pudong New Area People's Hospital, Shanghai 201299, P.R. China
| | - Quan Jiang
- Department of Ultrasound, Shanghai Pudong New Area People's Hospital, Shanghai 201299, P.R. China
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