Development and validation of apparent diffusion coefficient histogram-based nomogram for predicting malignant transformation of sinonasal inverted papilloma.
Meng Qi, Zhipeng Xia, Fang Zhang, Yan Sha, Jiliang Ren
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引用次数: 0
Abstract
Objectives: To develop and validate a nomogram based on whole-tumour histograms of apparent diffusion coefficient (ADC) maps for predicting malignant transformation (MT) in sinonasal inverted papilloma (IP).
Methods: This retrospective study included 209 sinonasal IPs with and without MT, which were assigned into a primary cohort (n = 140) and a validation cohort (n = 69). Eight ADC histogram features were extracted from the whole-tumour region of interest. Morphological MRI features and ADC histogram parameters were compared between the two groups (with and without MT). Stepwise logistic regression was used to identify independent predictors and to construct models. The predictive performances of variables and models were assessed using the area under the curve (AUC). The optimal model was presented as a nomogram, and its calibration was assessed.
Results: Four morphological features and seven ADC histogram parameters showed significant differences between the two groups in both cohorts (all p < 0.05). Maximum diameter, loss of convoluted cerebriform pattern, ADC10th and ADCSkewness were identified as independent predictors to construct the nomogram. The nomogram showed significantly better performance than the morphological model in both the primary (AUC, 0.96 vs 0.88; p = 0.006) and validation (AUC, 0.96 vs 0.88; p = 0.015) cohorts. The nomogram showed good calibration in both cohorts. Decision curve analysis demonstrated that the nomogram is clinically useful.
Conclusions: The developed nomogram, which incorporates morphological MRI features and ADC histogram parameters, can be conveniently used to facilitate the pre-operative prediction of MT in IPs.
期刊介绍:
Dentomaxillofacial Radiology (DMFR) is the journal of the International Association of Dentomaxillofacial Radiology (IADMFR) and covers the closely related fields of oral radiology and head and neck imaging.
Established in 1972, DMFR is a key resource keeping dentists, radiologists and clinicians and scientists with an interest in Head and Neck imaging abreast of important research and developments in oral and maxillofacial radiology.
The DMFR editorial board features a panel of international experts including Editor-in-Chief Professor Ralf Schulze. Our editorial board provide their expertise and guidance in shaping the content and direction of the journal.
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