Abstract：
OBJECTIVE: To establish a computed tomography (CT)-based scale to evaluate the resectability of locally advanced thyroid cancer.
METHODS: This twin-centre retrospective study included 95 locally advanced thyroid cancer patients from the 1st centre as the training cohort and 31 patients from the 2nd centre as the testing cohort, who were categorised into the resectable and unresectable groups. Three radiologists scored the CT scans of each patient by evaluating the extension to the recurrent laryngeal nerve (RLN), trachea, oesophagus, artery, vein, soft tissue, and larynx. A 14-score scale (including all comprised structures) and a 12-score scale (excluding larynx) were developed. Receiver-operating characteristic (ROC) analysis was used to evaluate the performance of the scales. Stratified fivefold cross-validation and external verification were used to validate the scale.
RESULTS: In the training cohort, compromised RLN (p < 0.001), trachea (p = 0.001), oesophagus (p = 0.002), artery (p < 0.001), vein (p = 0.005), and soft tissue (p < 0.001) were predictors for unresectability, while compromised larynx (p = 0.283) was not. The 12-score scale (AUC = 0.882, 95%CI: 0.812-0.952) was not inferior to the 14-score scale (AUC = 0.891, 95%CI: 0.823-0.960). In subgroup analysis, the AUCs of the 12-score scale were 0.826 for treatment-naïve patients and 0.976 for patients with prior surgery. The 12-score scale was further validated with a fivefold cross-validation analysis, with an overall accuracy of 78.9-89.4%. Finally, external validation using the testing cohort showed an AUC of 0.875.
CONCLUSIONS: The researchers built a CT-based 12-score scale to evaluate the resectability of locally advanced thyroid cancer. Validation with a larger sample size is required to confirm the efficacy of the scale.
CONCLUSIONS: This 12-score CT scale would help clinicians evaluate the resectability of locally advanced thyroid cancer.
CONCLUSIONS: • The researchers built a 12-score CT scale (including recurrent laryngeal nerve, trachea, oesophagus, artery, vein, and soft tissue) to evaluate the resectability of locally advanced thyroid cancer. • This scale has the potential to help clinicians make treatment plans for locally advanced thyroid cancer.
METHODS: This twin-centre retrospective study included 95 locally advanced thyroid cancer patients from the 1st centre as the training cohort and 31 patients from the 2nd centre as the testing cohort, who were categorised into the resectable and unresectable groups. Three radiologists scored the CT scans of each patient by evaluating the extension to the recurrent laryngeal nerve (RLN), trachea, oesophagus, artery, vein, soft tissue, and larynx. A 14-score scale (including all comprised structures) and a 12-score scale (excluding larynx) were developed. Receiver-operating characteristic (ROC) analysis was used to evaluate the performance of the scales. Stratified fivefold cross-validation and external verification were used to validate the scale.
RESULTS: In the training cohort, compromised RLN (p < 0.001), trachea (p = 0.001), oesophagus (p = 0.002), artery (p < 0.001), vein (p = 0.005), and soft tissue (p < 0.001) were predictors for unresectability, while compromised larynx (p = 0.283) was not. The 12-score scale (AUC = 0.882, 95%CI: 0.812-0.952) was not inferior to the 14-score scale (AUC = 0.891, 95%CI: 0.823-0.960). In subgroup analysis, the AUCs of the 12-score scale were 0.826 for treatment-naïve patients and 0.976 for patients with prior surgery. The 12-score scale was further validated with a fivefold cross-validation analysis, with an overall accuracy of 78.9-89.4%. Finally, external validation using the testing cohort showed an AUC of 0.875.
CONCLUSIONS: The researchers built a CT-based 12-score scale to evaluate the resectability of locally advanced thyroid cancer. Validation with a larger sample size is required to confirm the efficacy of the scale.
CONCLUSIONS: This 12-score CT scale would help clinicians evaluate the resectability of locally advanced thyroid cancer.
CONCLUSIONS: • The researchers built a 12-score CT scale (including recurrent laryngeal nerve, trachea, oesophagus, artery, vein, and soft tissue) to evaluate the resectability of locally advanced thyroid cancer. • This scale has the potential to help clinicians make treatment plans for locally advanced thyroid cancer.
摘要：
目的：建立基于计算机断层扫描（CT）的量表，以评估局部晚期甲状腺癌的可切除性。
方法：这项双中心回顾性研究包括来自第一中心的95名局部晚期甲状腺癌患者作为训练队列和来自第二中心的31名患者作为测试队列。将其分为可切除和不可切除组。三名放射科医生通过评估喉返神经（RLN）的延伸对每位患者的CT扫描进行评分，气管,食管,动脉,静脉,软组织,还有喉部.开发了14分量表（包括所有包含的结构）和12分量表（不包括喉）。接收器工作特性（ROC）分析用于评估秤的性能。采用分层五折交叉验证和外部验证对量表进行验证。
结果：在培训队列中，受损的RLN(p<0.001)，气管（p=0.001），食管（p=0.002），动脉（p<0.001），静脉（p=0.005），软组织（p<0.001）是不可切除的预测因素，而受损的喉部（p=0.283）则没有。12分量表（AUC=0.882，95CI：0.812-0.952）不亚于14分量表（AUC=0.891，95CI：0.823-0.960）。在亚组分析中，未接受治疗的患者的12分量表的AUC分别为0.826和0.976.12分量表进行了5倍交叉验证分析，总体准确率为78.9-89.4%。最后,使用测试队列的外部验证显示AUC为0.875.
结论：研究人员建立了基于CT的12分量表来评估局部晚期甲状腺癌的可切除性。需要用较大的样本量进行验证以确认量表的功效。
结论：该12分CT量表有助于临床医生评估局部晚期甲状腺癌的可切除性。
结论：•研究人员建立了12分CT量表（包括喉返神经，气管,食管,动脉,静脉,和软组织）以评估局部晚期甲状腺癌的可切除性。•该量表有可能帮助临床医生制定局部晚期甲状腺癌的治疗计划。
方法：这项双中心回顾性研究包括来自第一中心的95名局部晚期甲状腺癌患者作为训练队列和来自第二中心的31名患者作为测试队列。将其分为可切除和不可切除组。三名放射科医生通过评估喉返神经（RLN）的延伸对每位患者的CT扫描进行评分，气管,食管,动脉,静脉,软组织,还有喉部.开发了14分量表（包括所有包含的结构）和12分量表（不包括喉）。接收器工作特性（ROC）分析用于评估秤的性能。采用分层五折交叉验证和外部验证对量表进行验证。
结果：在培训队列中，受损的RLN(p<0.001)，气管（p=0.001），食管（p=0.002），动脉（p<0.001），静脉（p=0.005），软组织（p<0.001）是不可切除的预测因素，而受损的喉部（p=0.283）则没有。12分量表（AUC=0.882，95CI：0.812-0.952）不亚于14分量表（AUC=0.891，95CI：0.823-0.960）。在亚组分析中，未接受治疗的患者的12分量表的AUC分别为0.826和0.976.12分量表进行了5倍交叉验证分析，总体准确率为78.9-89.4%。最后,使用测试队列的外部验证显示AUC为0.875.
结论：研究人员建立了基于CT的12分量表来评估局部晚期甲状腺癌的可切除性。需要用较大的样本量进行验证以确认量表的功效。
结论：该12分CT量表有助于临床医生评估局部晚期甲状腺癌的可切除性。
结论：•研究人员建立了12分CT量表（包括喉返神经，气管,食管,动脉,静脉,和软组织）以评估局部晚期甲状腺癌的可切除性。•该量表有可能帮助临床医生制定局部晚期甲状腺癌的治疗计划。
