Development and validation of an ultrasound-based nomogram to improve the diagnostic accuracy for malignant thyroid nodules.

Objectives: The aim of this study was to develop an ultrasound-based nomogram to improve the diagnostic accuracy of the identification of malignant thyroid nodules.Methods: A total of 1675 histologically proven thyroid nodules (1169 benign, 506 malignant) were included in this study. The nodules wer...

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Publicado en:European Radiology Vol. 29; no. 3; pp. 1518 - 1527
Autores principales: Guo, Bao-liang, Ouyang, Fu-sheng, Ouyang, Li-zhu, Liu, Zi-wei, Lin, Shao-jia, Meng, Wei, Huang, Xi-yi, Chen, Hai-xiong, Yang, Shao-ming, Hu, Qiu-gen
Formato: research Journal Article
Publicado: Springer Nature Mar2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2019
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      pub: Springer Nature
      place: New York, New York
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        atl: Development and validation of an ultrasound-based nomogram to improve the diagnostic accuracy for malignant thyroid nodules.
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        au:
          Guo, Bao-liang
          Ouyang, Fu-sheng
          Ouyang, Li-zhu
          Liu, Zi-wei
          Lin, Shao-jia
          Meng, Wei
          Huang, Xi-yi
          Chen, Hai-xiong
          Yang, Shao-ming
          Hu, Qiu-gen
        affil: Department of Radiology, Shunde Hospital of Southern Medical University (The First People's Hospital of Shunde), No.1, Penglai Road, Daliang District, Shunde, Foshan, Guangdong, People's Republic of China
      sug:
        subj:
          Ultrasonography Methods
          Models, Statistical
          Thyroid Nodule
          Aged
          Young Adult
          Thyroid Gland
          Female
          Human
          Retrospective Design
          Thyroid Gland Pathology
          Diagnosis, Differential
          Reproducibility of Results
          Middle Age
          Male
          Aged, 80 and Over
          Thyroid Nodule Pathology
          Adult
          Adolescence
          ROC Curve
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Aged: 65+ years
          Middle Aged: 45-64 years
          Aged, 80 & over
          Adult: 19-44 years
          Adolescent: 13-18 years
          Female
          Male
      ab: Objectives: The aim of this study was to develop an ultrasound-based nomogram to improve the diagnostic accuracy of the identification of malignant thyroid nodules.Methods: A total of 1675 histologically proven thyroid nodules (1169 benign, 506 malignant) were included in this study. The nodules were grouped into the training dataset (n = 700), internal validation dataset (n = 479), or external validation dataset (n = 496). The grayscale ultrasound features included the nodule size, shape, aspect ratio, echogenicity, margins, and calcification pattern. We applied least absolute shrinkage and selection operator (lasso) regression to select the strongest features for the nomogram. Nomogram discrimination (area under the receiver operating characteristic curve, AUC) and calibration were assessed. The nomogram was subjected to bootstrapping validation (1000 bootstrap resamples) to calculate a mean AUC and 95% confidence interval (CI).Results: The nomogram showed good discrimination in the training dataset, with an AUC of 0.936 (95% CI: 0.918-0.953) and good calibration. Application of the nomogram to the internal validation dataset also resulted in good discrimination (AUC: 0.935; 95% CI, 0.915-0.954) and good calibration. The model tested in an external validation dataset demonstrated a lower AUC of 0.782 (95% CI: 0.776-0.789).Conclusions: This ultrasound-based nomogram can be used to quantify the probability of malignant thyroid nodules.Key Points: • Ultrasound examination is helpful in the differential diagnosis of malignant and benign thyroid nodules. • However, ultrasound accuracy relies heavily on examiner experience. • A less subjective diagnostic model is desired, and the developed nomogram for thyroid nodules showed good discrimination and good calibration.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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