Multimodality MRI-based radiomics for aggressiveness prediction in papillary thyroid cancer

Objective: To investigate the ability of a multimodality MRI-based radiomics model in predicting the aggressiveness of papillary thyroid carcinoma (PTC). Methods: This study included consecutive patients who underwent neck magnetic resonance (MR) scans and subsequent thyroidectomy during the study period. The pathological diagnosis of thyroidectomy specimens was the gold standard to determine the aggressiveness. Thyroid nodules were manually segmented on three modal MR images, and then radiomics features were extracted. A machine learning model was established to evaluate the prediction of PTC aggressiveness. Results: The study cohort included 107 patients with PTC confirmed by pathology (cross-validation cohort: n = 71; test cohort: n = 36). A total of 1584 features were extracted from contrast-enhanced T1-weighted (CE-T1 WI), T2-weighted (T2 WI) and diffusion weighted (DWI) images of each patient. Sparse representation method is used for radiation feature selection and classification model establishment. The accuracy of the independent test set that using only one modality, like CE-T1WI, T2WI or DWI was not particularly satisfactory. In contrast, the result of these three modalities combined achieved 0.917. Conclusion: Our study shows that multimodality MR image based on radiomics model can accurately distinguish aggressiveness in PTC from non-aggressiveness PTC before operation. This method may be helpful to inform the treatment strategy and prognosis of patients with aggressiveness PTC.