Intra- and Peritumoral Radiomics Based on Ultrasound Images for Preoperative Differentiation of Follicular Thyroid Adenoma, Carcinoma, and Follicular Tumor With Uncertain Malignant Potential.
Authors
Affiliations (6)
Affiliations (6)
- Department of Ultrasound, Peking University Third Hospital, Beijing, China.
- Department of Pathology, Peking University Third Hospital, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China.
- Department of Radiology, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China.
- Department of Ultrasound, Heilongjiang Shuangyashan Shuangkuang Hospital, Shuangyashan, China.
- Department of Ultrasound, The People's Hospital of Anyang city, Anyang, China.
- Department of Ultrasound, Peking University Third Hospital, Beijing, China. Electronic address: [email protected].
Abstract
Differentiating between follicular thyroid adenoma (FTA), carcinoma (FTC), and follicular tumor with uncertain malignant potential (FT-UMP) remains challenging due to their overlapping ultrasound characteristics. This retrospective study aimed to enhance preoperative diagnostic accuracy by utilizing intra- and peritumoral radiomics based on ultrasound images. We collected post-thyroidectomy ultrasound images from 774 patients diagnosed with FTA (n = 429), FTC (n = 158), or FT-UMP (n = 187) between January 2018 and December 2023. Six peritumoral regions were expanded by 5%-30% in 5% increments, with the segment-anything model utilizing prompt learning to detect the field of view and constrain the expanded boundaries. A stepwise classification strategy addressing three tasks was implemented: distinguishing FTA from the other types (task 1), differentiating FTC from FT-UMP (task 2), and classifying all three tumors. Diagnostic models were developed by combining radiomic features from tumor and peritumoral regions with clinical characteristics. Clinical characteristics combined with intratumoral and 5% peritumoral radiomic features performed best across all tasks (Test set: area under the curves, 0.93 for task 1 and 0.90 for task 2; diagnostic accuracy, 79.9%). The DeLong test indicated that all peritumoral radiomics significantly improved intratumoral radiomics performance and clinical characteristics (p < 0.04). The 5% peritumoral regions showed the best performance, though not all results were significant (p = 0.01-0.91). Ultrasound-based intratumoral and peritumoral radiomics can significantly enhance preoperative diagnostic accuracy for FTA, FTC, and FT-UMP, leading to improved treatment strategies and patient outcomes. Furthermore, the 5% peritumoral area may indicate regions of potential tumor invasion requiring further investigation.