Nomogram model based on ultrasound image features for accurate qualitative diagnosis of enlarged cervical lymph nodes
YUAN Hong
WEN Wen
RUAN Juan
ZHAO Haina
LIU Jingyan
PENG Yulan
Abstract：Objective To establish a qualitative diagnostic nomogram for cervical lymph nodes(CLNs)based on ultrasonographic characteristics.Methods A retrospective study was conducted on 2,697 patients who underwent fine needle aspiration of CLNs at West China Hospital of Sichuan University from January 2020 to December 2023.The analysis encompassed a total of 3014 enlarged CLNs,which were categorised into 1489 benign and 1525 malignant cases based on pathological findings.Clinicopathplogical information,B-mode ultrasound images,and color Doppler ultrasound images were systematically collected.Two experienced radiologists independently reviewed the imaging features of the lymph nodes.The patients were randomly assigned to a training cohort and a validation cohort at a ratio of 7:3.In the validation cohort,univariate analysis and multivariate logistic regression analysis were performed to identify candidate features associated with benign or malignant CLN.The construction of the nomogram model was facilitated by the identified candidate features.ROC curves were plotted in both the training and validation sets to evaluate diagnostic performance by calculating sensitivity,specificity,and accuracy.Calibration curves were utilised to evaluate the concordance between predicted probabilities and observed outcomes,while clinical decision curve analysis was employed to assess the clinical utility of the model.Results Based on univariate and multivariate analysis,ten features were integrated into the nomogram model ultimately.This model exhibited an AUC of 0.942 in the training cohort and 0.925 in the validation cohort,significantly exceeding the performance of conventional ultrasound qualitative diagnosis(AUC=0.656,P<0.001).The ultrasound features incorporated into the model included the long-axis diameter,short-axis diameter,long-to-short axis ratio,cortical echogenicity pattern,cortical homogeneity,corticomedullary demarcation,hilum visualization,margin,shape,and calcification.Conclusion The ultrasonography-based nomogram demonstrates superior diagnostic performance in the qualitative assessment of CLN compared to conventional ultrasonographic diagnostic methods,thereby offering valuable guidance for formulating subsequent clinical management strategies in patients presenting with cervical lymphadenopathy.
Keywords：cervical lymph nodesultrasoundNomogram
Publication Date：2025-04-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 405-411 )