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A CT-based radiomics nomogram for differentiation of lympho-associated benign and malignant lesions of the parotid gland

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Abstract

Objectives

Preoperative differentiation between benign lymphoepithelial lesion (BLEL) and mucosa-associated lymphoid tissue lymphoma (MALToma) in the parotid gland is important for treatment decisions. The purpose of this study was to develop and validate a CT-based radiomics nomogram combining radiomics signature and clinical factors for the preoperative differentiation of BLEL from MALToma in the parotid gland.

Methods

A total of 101 patients with BLEL (n = 46) or MALToma (n = 55) were divided into a training set (n = 70) and validation set (n = 31). Radiomics features were extracted from non-contrast CT images, a radiomics signature was constructed, and a radiomics score (Rad-score) was calculated. Demographics and CT findings were assessed to build a clinical factor model. A radiomics nomogram combining the Rad-score and independent clinical factors was constructed using multivariate logistic regression analysis. The performance levels of the nomogram, radiomics signature, and clinical model were evaluated and validated on the training and validation datasets, and then compared among the three models.

Results

Seven features were used to build the radiomics signature. The radiomics nomogram incorporating the clinical factors and radiomics signature showed favorable predictive value for differentiating parotid BLEL from MALToma, with AUCs of 0.983 and 0.950 for the training set and validation set, respectively. Decision curve analysis showed that the nomogram outperformed the clinical factor model in terms of clinical usefulness.

Conclusions

The CT-based radiomics nomogram incorporating the Rad-score and clinical factors showed favorable predictive efficacy for differentiating BLEL from MALToma in the parotid gland, and may help in the clinical decision-making process.

Key Points

• Differential diagnosis between BLEL and MALToma in parotid gland is rather difficult by conventional imaging modalities.

• A radiomics nomogram integrated with the radiomics signature, demographics, and CT findings facilitates differentiation of BLEL from MALToma with improved diagnostic efficacy.

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Abbreviations

3-D:

Three-dimensional

ANOVA:

Analysis of variance

AUC:

Area under the curve

BLEL:

Benign lymphoepithelial lesion

CI:

Confidence interval

DCA:

Decision curve analysis

DCE:

Dynamic contrast-enhanced

DWI:

Diffusion-weighted imaging

GLCM:

Gray-level co-occurrence matrix

GLDM:

Gray-level dependence matrix

GLRLM:

Gray-level run length matrix

GLSZM:

Gray-level size zone matrix

ICC:

Inter-/intra- class correlation coefficient

LASSO:

Least absolute shrinkage and selection operator

MALT:

Mucosa-associated lymphoid tissue lymphoma

NGTDM:

Neighboring gray tone difference matrix

Nomo-score:

Nomogram score

OR:

Odds ratio

Rad-score:

Radiomics score

ROC:

Receiver operating characteristic

ROI:

Region of interest

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Acknowledgments

We thank Karl Embleton, PhD, from Liwen Bianji, Edanz Group China (www.liwenbianji.cn/ac), for editing the English text of a draft of this manuscript.

Funding

The authors state that this work has not received any funding.

Author information

Authors and Affiliations

  1. Health Management Center, The Affiliated Hospital of Qingdao University, No.16, Jiangsu Road, Qingdao, 266000, China

    Ying-mei Zheng

  2. Department of Radiology, The Affiliated Hospital of Qingdao University, No.16, Jiangsu Road, Qingdao, 266000, China

    Wen-jian Xu, Da-peng Hao, Xue-jun Liu, Chuan-ping Gao, Jie Li, He-xiang Wang & Cheng Dong

  3. Department of Cardiac Ultrasound, The Affiliated Hospital of Qingdao University, No.16, Jiangsu Road, Qingdao, 266000, China

    Guo-zhang Tang

Authors
  1. Ying-mei Zheng
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  4. Xue-jun Liu
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  9. Cheng Dong
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Corresponding author

Correspondence to Cheng Dong.

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The scientific guarantor of this publication is Da-peng Hao.

Conflict of interest

The authors declare that they have no conflict of interest.

Statistics and biometry

One of the authors (Da-peng Hao) has significant statistical expertise and is identified as the statistical guarantor for the statistical analysis used in this study.

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Written informed consent was obtained from all subjects (patients) in this study.

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Institutional Review Board approval was obtained.

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• diagnostic study/observational/

• performed at one institution

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Zheng, Ym., Xu, Wj., Hao, Dp. et al. A CT-based radiomics nomogram for differentiation of lympho-associated benign and malignant lesions of the parotid gland. Eur Radiol 31, 2886–2895 (2021). https://doi.org/10.1007/s00330-020-07421-4

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  • DOI: https://doi.org/10.1007/s00330-020-07421-4

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