Ultrasound feature-based nomogram model for predicting extrathyroidal extension in papillary thyroid carcinoma
Abstract Background The ultrasound diagnostic system for extrathyroidal extension (ETE) of papillary thyroid carcinoma (PTC) has not been thoroughly explored. To develop and validate a nomogram model based on ultrasound features to predict ETE of papillary thyroid carcinoma for preoperative assessme...
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BMC
2025-07-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-025-14613-y |
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| author | Dong Guo Chen Chen Yin Zheng Yue Shan Shifei Huang Tianhan Zhou Yefei Yao Zhengxian Zhang Lu Wang Dong Xu |
| author_facet | Dong Guo Chen Chen Yin Zheng Yue Shan Shifei Huang Tianhan Zhou Yefei Yao Zhengxian Zhang Lu Wang Dong Xu |
| author_sort | Dong Guo |
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| description | Abstract Background The ultrasound diagnostic system for extrathyroidal extension (ETE) of papillary thyroid carcinoma (PTC) has not been thoroughly explored. To develop and validate a nomogram model based on ultrasound features to predict ETE of papillary thyroid carcinoma for preoperative assessment. Methods The training set retrospectively included 560 patients from two hospitals with preoperative ultrasound images showing capsule contact and confirmed as unifocal PTC by surgical pathology. The external validation set prospectively included 150 PTC patients with similar features and dynamic ultrasound videos. Univariate and multivariate logistic regression analyses were used to identify independent predictors of ETE in PTC, and an ETE nomogram prediction model was constructed to predict the risk of ETE in capsule-contacting PTC. The predictive efficiency of the model was evaluated using receiver operating characteristic (ROC) curve and calibration curves, and the clinical value of the model was determined through decision curve analysis (DCA). Results Among 710 capsule-contacting unifocal PTC patients, the incidence of ETE was 66.62% (473/710). Independent predictors of ETE were: Capsule bulging (OR = 8.951, 95%CI: 5.192–15.134), capsule contact angle ≥ 90° (OR = 2.331, 95%CI: 1.405–3.868), capsule contact extent ≥ 25% (OR = 5.708, 95%CI: 3.429–9.503), irregular morphology (OR = 1.856, 95%CI: 1.114–3.094), and coarse margins (OR = 4.198, 95%CI: 2.396–7.352). Based on these factors, an ETE nomogram diagnostic prediction model for PTC was established. The model’s ROC curve demonstrated an area under the curve (AUC) of 0.887 (95% CI: 0.857–0.917), with diagnostic sensitivity, specificity, and accuracy of 0.811, 0.799 and 0.807, respectively. The AUC of the external validation set was 0.896 (95% CI: 0.847–0.945), with diagnostic sensitivity, specificity, and accuracy of 0.862, 0.762, and 0.820, respectively. The calibration curve showed good consistency between the predicted and actual probabilities of ETE. DCA showed that the model had good clinical application value. Conclusion The ETE nomogram scoring prediction model based on conventional ultrasound features can provide a relatively convenient and intuitive preoperative quantitative assessment of ETE in PTC, serving as a reference for clinical decision-making. |
| format | Article |
| id | doaj-art-6c8ebfd2fe314e768fb7029bead33c38 |
| institution | Kabale University |
| issn | 1471-2407 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
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| series | BMC Cancer |
| spelling | doaj-art-6c8ebfd2fe314e768fb7029bead33c382025-08-20T04:03:07ZengBMCBMC Cancer1471-24072025-07-0125111010.1186/s12885-025-14613-yUltrasound feature-based nomogram model for predicting extrathyroidal extension in papillary thyroid carcinomaDong Guo0Chen Chen1Yin Zheng2Yue Shan3Shifei Huang4Tianhan Zhou5Yefei Yao6Zhengxian Zhang7Lu Wang8Dong Xu9Department of Ultrasound, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medicine UniversityDepartment of Diagnostic Ultrasound Imaging & Interventional Therapy, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of SciencesSecond Clinical School of Zhejiang Chinese Medicine UniversityDepartment of Ultrasound, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medicine UniversityDepartment of General Surgery, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medicine UniversityDepartment of General Surgery, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medicine UniversityDepartment of Ultrasound, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medicine UniversityDepartment of Ultrasound, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medicine UniversityDepartment of Ultrasound, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medicine UniversityDepartment of Diagnostic Ultrasound Imaging & Interventional Therapy, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of SciencesAbstract Background The ultrasound diagnostic system for extrathyroidal extension (ETE) of papillary thyroid carcinoma (PTC) has not been thoroughly explored. To develop and validate a nomogram model based on ultrasound features to predict ETE of papillary thyroid carcinoma for preoperative assessment. Methods The training set retrospectively included 560 patients from two hospitals with preoperative ultrasound images showing capsule contact and confirmed as unifocal PTC by surgical pathology. The external validation set prospectively included 150 PTC patients with similar features and dynamic ultrasound videos. Univariate and multivariate logistic regression analyses were used to identify independent predictors of ETE in PTC, and an ETE nomogram prediction model was constructed to predict the risk of ETE in capsule-contacting PTC. The predictive efficiency of the model was evaluated using receiver operating characteristic (ROC) curve and calibration curves, and the clinical value of the model was determined through decision curve analysis (DCA). Results Among 710 capsule-contacting unifocal PTC patients, the incidence of ETE was 66.62% (473/710). Independent predictors of ETE were: Capsule bulging (OR = 8.951, 95%CI: 5.192–15.134), capsule contact angle ≥ 90° (OR = 2.331, 95%CI: 1.405–3.868), capsule contact extent ≥ 25% (OR = 5.708, 95%CI: 3.429–9.503), irregular morphology (OR = 1.856, 95%CI: 1.114–3.094), and coarse margins (OR = 4.198, 95%CI: 2.396–7.352). Based on these factors, an ETE nomogram diagnostic prediction model for PTC was established. The model’s ROC curve demonstrated an area under the curve (AUC) of 0.887 (95% CI: 0.857–0.917), with diagnostic sensitivity, specificity, and accuracy of 0.811, 0.799 and 0.807, respectively. The AUC of the external validation set was 0.896 (95% CI: 0.847–0.945), with diagnostic sensitivity, specificity, and accuracy of 0.862, 0.762, and 0.820, respectively. The calibration curve showed good consistency between the predicted and actual probabilities of ETE. DCA showed that the model had good clinical application value. Conclusion The ETE nomogram scoring prediction model based on conventional ultrasound features can provide a relatively convenient and intuitive preoperative quantitative assessment of ETE in PTC, serving as a reference for clinical decision-making.https://doi.org/10.1186/s12885-025-14613-yPapillary thyroid carcinomaCapsule contactExtrathyroidal extensionNomogram |
| spellingShingle | Dong Guo Chen Chen Yin Zheng Yue Shan Shifei Huang Tianhan Zhou Yefei Yao Zhengxian Zhang Lu Wang Dong Xu Ultrasound feature-based nomogram model for predicting extrathyroidal extension in papillary thyroid carcinoma BMC Cancer Papillary thyroid carcinoma Capsule contact Extrathyroidal extension Nomogram |
| title | Ultrasound feature-based nomogram model for predicting extrathyroidal extension in papillary thyroid carcinoma |
| title_full | Ultrasound feature-based nomogram model for predicting extrathyroidal extension in papillary thyroid carcinoma |
| title_fullStr | Ultrasound feature-based nomogram model for predicting extrathyroidal extension in papillary thyroid carcinoma |
| title_full_unstemmed | Ultrasound feature-based nomogram model for predicting extrathyroidal extension in papillary thyroid carcinoma |
| title_short | Ultrasound feature-based nomogram model for predicting extrathyroidal extension in papillary thyroid carcinoma |
| title_sort | ultrasound feature based nomogram model for predicting extrathyroidal extension in papillary thyroid carcinoma |
| topic | Papillary thyroid carcinoma Capsule contact Extrathyroidal extension Nomogram |
| url | https://doi.org/10.1186/s12885-025-14613-y |
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