Korean J Intern Med > Epub ahead of print
ORIGINAL ARTICLE
Fisher discriminant analysis of multimodal ultrasound in diagnosis of cervical metastatic lymph nodes in papillary thyroid cancer
Yixuan Wang, Yue Han, Fei Li, Yuyang Lin, and Bei Wang
Department of Medical Ultrasound, Shandong Medicine and Health Key Laboratory of Abdominal Medical Imaging, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
Corresponding Author: Bei Wang  , Tel: +8618853182401, Email: wangbei1224@126.com
Received: April 9, 2024;   Revised: May 20, 2024;   Accepted: July 25, 2024.
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Abstract
Background/Aims: The purpose of this study was to develop a diagnostic model utilizing multimodal ultrasound parameters to aid in the detection of cervical lymph node metastasis in papillary thyroid cancer (PTC) patients.
Methods: The study included 84 suspicious lymph nodes from 69 PTC patients, all of whom underwent fine needle aspiration with pathological results. Data from conventional grayscale ultrasound, shear wave elastography (SWE), and superb microvascular imaging were analyzed. Key ultrasound features were compared between benign and metastatic groups to create a diagnostic model using Fisher’s stepwise discriminant analysis. The model’s effectiveness was assessed with self-testing, cross-validation, and receiver operating characteristic curve analysis.
Results: Four features, namely lymphatic hilum (X1), cortical hyperechogenicity (X2), vascular pattern (X4), and SWEmean (X7), were integral to the discriminant analysis, resulting in the equation: Y1 = -3.461 + 2.423X1 + 0.321X2 + 1.620X4 + 0.109X7, Y2 = -8.053 + 0.414X1 + 2.600X2 + 2.504X4 + 0.192X7. If Y1 < Y2, the LN would be diagnosed as metastatic lymph nodes. The model demonstrated an area under the curve of 0.833, with a sensitivity of 83.33% and specificity of 83.33%.
Conclusions: The multimodal ultrasound diagnostic model, established through Fisher’s stepwise discriminant analysis, proved effective in identifying metastatic lymph nodes in PTC patients.
Keywords: Lymphatic metastasis ; Thyroid neoplasms ; Diagnostic imaging ; Elasticity imaging technique ; Discriminant analysis
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