The diagnostic value of MRI T2WI image texture analysis for predicting cervical lymph node metastasis of papillary thyroid carcinoma
ZHANG Heng1, ZHANG Hui-hui1, SHU Zheng2, GE Chen-jin2, DENG Xiao-fei2, SUN Feng2, CAO Sheng-nan2
1. Graduate School of Bengbu Medical College, Bengbu Anhui 233030, China; 2. Shanghai Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200082, China
Abstract：Objective: To evaluate the value of MRI texture analysis in predicting cervical lymph node metastasis of papillary thyroid carcinoma(PTC). Materials and Methods: The imaging and clinical data of 54 patients with PTC diagnosed by operation and pathology were retrospectively analyzed, according to the result of surgical pathology, the patients were divided into lymph node metastasis group(34 cases) and no lymph node metastasis group(20 cases). Preoperative thyroid MRI examination was performed on all patients, ROI was manually delineated on the T2WI axial image of the largest section of the tumor, texture parameters(entropy, standard deviation, contrast, skewness, kurtosis, deficit moment, angular second moment, mean, correlation) were extracted by texture analysis software. The independent sample t-test(normal distribution with homogeneity of variance) and Mann-Whitney U test(non-normal distribution without homogeneity of variance) were used to compare the differences of measurement data between the two groups. The difference of enumeration data was compared by χ2 test. The ROC curve was used to evaluate the texture parameters with statistical significance and to predict the efficacy of cervical lymph node metastasis. P<0.05 was considered statistically significant. Results: The T2WI image entropy(t=-5.64), correlation(Z=-2.67), angular second-order moment(Z=-3.53) and standard deviation(Z=-2.67) between PTC cervical lymph node metastasis group and non-metastasis group were statistically significant(P<0.05). The maximum of the area under ROC curve(AUC) of entropy was 0.884, threshold was 5.59, sensitivity was 97.1%, and specificity was 70%. Contrast, skewness, kurtosis, deficit moment and mean were not statistically significant(P>0.05). Conclusion: MRI T2WI image texture analysis has certain significance for prediction of PTC cervical lymph node metastasis.
张 衡1，张慧慧1，舒 政2，葛琛瑾2，邓小飞2，孙 凤2，曹胜男2. MRI T2WI图像纹理分析预测甲状腺乳头状癌颈部淋巴结转移的诊断价值
[J]. 中国临床医学影像杂志, 2020, 31(8): 568-571.
ZHANG Heng1, ZHANG Hui-hui1, SHU Zheng2, GE Chen-jin2, DENG Xiao-fei2, SUN Feng2, CAO Sheng-nan2. The diagnostic value of MRI T2WI image texture analysis for predicting cervical lymph node metastasis of papillary thyroid carcinoma. JOURNAL OF CHINA MEDICAL IMAGING, 2020, 31(8): 568-571.
[1]Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016, 66(2): 115-132.
[2]Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer[J]. Thyroid, 2016, 26(1): 1-133.
[3]Chen L, Zhu Y, Zheng K, et al. The presence of cancerous nodules in lymph nodes is a novel indicator of distant metastasis and poor survival in patients with papillary thyroid carcinoma[J]. J Cancer Res Clin Oncol, 2017, 143(6): 1035-1042.
[4]Eun NL, Son EJ, Kim JA, et al. Comparison of the diagnostic performances of ultrasonography, CT and fine needle aspiration cytology for the prediction of lymph node metastasis in patients with lymph node dissection of papillary thyroid carcinoma: A retrospective cohort study[J]. Int J Surg, 2018, 51: 145-150.
[5]于浩鹏，李谋，张琳，等. CT图像纹理分析评估胰腺神经内分泌肿瘤的病理分级[J]. 中国临床医学影像杂志，2018，29（11）：788-791.
[6]Kim SY, Lee E, Nam SJ, et al. Ultrasound texture analysis: Association with lymph node metastasis of papillary thyroid microcarcinoma[J]. PloS one, 2017, 12(4): e0176103.
[7]Liu T, Zhou S, Yu J, et al. Prediction of Lymph Node Metastasis in Patients With Papillary Thyroid Carcinoma: A Radiomics Method Based on Preoperative Ultrasound Images[J]. Technol Cancer Res Treat, 2019, 18: 1533033819831713.
[8]Liu C, Xiao C, Chen J, et al. Risk factor analysis for predicting cervical lymph node metastasis in papillary thyroid carcinoma: a study of 966 patients[J]. BMC Cancer, 2019, 19(1): 622-631.
[9]中华医学会内分泌学分会，中华医学会外科学分会内分泌学组，中国抗癌协会头颈肿瘤专业委员会，等. 甲状腺结节和分化型甲状腺癌诊治指南[J]. 中华核医学与分子影像杂志，2013，33（2）：96-115.
[10]Yang L, Shen W, Sakamoto N. Population-based study evaluating and predicting the probability of death resulting from thyroid cancer and other causes among patients with thyroid cancer[J]. J Clin Oncol, 2013, 31(4): 468-474.
[11]Sancho JJ, Lennard TW, Paunovic I, et al. Prophylactic central neck disection in papillary thyroid cancer: a consensus report of the European Society of Endocrine Surgeons(ESES)[J]. Langenbecks Arch Surg, 2014, 399(2): 155-163.
[12]陈曦. 分化型甲状腺癌术前影像及穿刺病理诊断评估[J]. 中华普外科手术学杂志：电子版，2016，10（5）：568-572.
[13]Castellano G, Bonilha L, Li LM, et al. Texture analysis of medical images[J]. Clin Radiol, 2004, 59(12): 1061-1069.
[14]钟熹，江魁明，麦慧，等. 基于灰度共生矩阵的MRI纹理分析预测舌癌患者颈部淋巴结转移的价值初探[J]. 中华放射学杂志，2018，52（9）：649-654.
[15]Schob S, Meyer HJ, Dieckow J, et al. Histogram Analysis of Diffusion Weighted Imaging at 3T is Useful for Prediction of Lymphatic Metastatic Spread, Proliferative Activity, and Cellularity in Thyroid Cancer[J]. Int J Mol Sci, 2017, 18(4): 821-832.
[16]Horvat N, Veeraraghavan H, Khan M, et al. MR Imaging of Rectal Cancer: Radiomics Analysis to Assess Treatment Response after Neoadjuvant Therapy[J]. Radiology, 2018, 287(3): 833-843.
[17]Brown AM, Nagala S, McLean MA, et al. Multi-institutional validation of a novel textural analysis tool for preoperative stratification of suspected thyroid tumors on diffusion-weighted MRI[J]. Magn Reson Med, 2016, 75(4): 1708-1716.
