Predicting Central Lymph Node Metastasis in Papillary Thyroid Carcinoma: Integration of Two-Dimensional Ultrasound Radiomics with Clinical Features

Abstract

tests, Spearman correlation analysis, and least absolute shrinkage and selection operator regression, yielding a radiomics signature (Rad-score). Seven machine-learning algorithms-logistic regression, support vector machine, k-nearest neighbors, decision tree, random forest, light gradient boosting machine, and gaussian naïve bayes-were compared to identify the optimal classifier. A joint predictive model was then constructed by integrating the Rad-score with clinically significant variables identified by univariate and multivariate logistic regression, and implemented using the optimal machine-learning classifier. Model performance was comprehensively evaluated using the area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis. Among the seven algorithms, gaussian naïve bayes achieved the highest predictive performance. Univariate and multivariate logistic regression revealed that sex, age, and tumor aspect ratio were independent predictors of CLNM. These variables were integrated with the Rad-score to yield a joint model that achieved AUCs of 0.840 (95% CI, 0.806-0.873) and 0.811 (95% CI, 0.746-0.866) in the training and test cohorts, respectively. Calibration curves and decision curve analysis indicated that the joint model was well-calibrated and afforded favorable clinical utility. The joint model integrating two-dimensional ultrasound radiomics with clinical features enables effective preoperative prediction of CLNM in PTC.

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