CT-based radiomics features for the differential diagnosis of nodular goiter and papillary thyroid carcinoma: an analysis employing propensity score matching

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Purpose: This study aims to evaluate the effectiveness of CT-based radiomics features in discriminating between nodular goiter (NG) and papillary thyroid carcinoma (PTC). Methods: A retrospective cohort comprising 228 patients with nodular goiter (NG) and 227 patients with papillary thyroid carcinoma (PTC) diagnosed between January 2018 and December 2022 was consecutively enrolled. Propensity score matching (PSM) was applied to align patients with NG and PTC. A total of 851 radiomics features were extracted from CT images acquired during the arterial phase for each individual. Feature selection was carried out utilizing the least absolute shrinkage and selection operator (LASSO) logistic regression algorithm to generate the radiomics score (Rad-score). Subsequently, the Rad-score was incorporated into a multivariate logistic regression analysis to construct a radiomics nomogram for visual representation. Results: Following PSM implementation, 101 patients diagnosed with NG were matched with an equivalent number of patients diagnosed with PTC. The developed radiomics score exhibited excellent predictive performance in distinguishing between NG and PTC, with high values of AUC, sensitivity, and specificity in both the training cohort (AUC = 0.823, accuracy = 0.759, sensitivity = 0.794, specificity = 0.740) and validation cohort (AUC = 0.904, accuracy = 0.820, sensitivity = 0.758, specificity = 0.964). Conclusion: The utilization of CT-based radiomics analysis following PMS offers a quantitative and data-driven approach to enhance the accuracy of distinguishing between nodular goiter (NG) and papillary thyroid carcinoma (PTC).

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