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A CT-based radiomics nomogram for differentiation of squamous cell carcinoma and non-Hodgkin’s lymphoma of the palatine tonsil

  • Head and Neck
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Abstract

Objectives

Accurate preoperative differentiation between squamous cell carcinoma (SCC) and non-Hodgkin’s lymphoma (NHL) in the palatine tonsil is crucial because of their different treatment. This study aimed to construct and validate a contrast-enhanced CT (CECT)–based radiomics nomogram for preoperative differentiation of SCC and NHL in the palatine tonsil.

Methods

This study enrolled 135 patients with a pathological diagnosis of SCC or NHL from two clinical centers, who were divided into training (n = 94; SCC = 50, NHL = 44) and external validation sets (n = 41; SCC = 22, NHL = 19). A radiomics signature was constructed from radiomics features extracted from routine CECT images and a radiomics score (Rad-score) was calculated. A clinical model was established using demographic features and CT findings. The independent clinical factors and Rad-score were combined to construct a radiomics nomogram. Performance of the clinical model, radiomics signature, and nomogram was assessed using receiver operating characteristics analysis and decision curve analysis.

Results

Eleven features were finally selected to construct the radiomics signature. The radiomics nomogram incorporating gender, mean CECT value, and radiomics signature showed better predictive value for differentiating SCC from NHL than the clinical model for training (AUC, 0.919 vs. 0.801, p = 0.004) and validation (AUC, 0.876 vs. 0.703, p = 0.029) sets. Decision curve analysis demonstrated that the radiomics nomogram was more clinically useful than the clinical model.

Conclusions

A CECT-based radiomics nomogram was constructed incorporating gender, mean CECT value, and radiomics signature. This nomogram showed favorable predictive efficacy for differentiating SCC from NHL in the palatine tonsil, and might be useful for clinical decision-making.

Key Points

• Differential diagnosis between SCC and NHL in the palatine tonsil is difficult by conventional imaging modalities.

• A radiomics nomogram integrated with the radiomics signature, gender, and mean contrast-enhanced CT value facilitates differentiation of SCC from NHL with improved diagnostic efficacy.

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Abbreviations

3D:

Three dimensional

ANOVA:

Analysis of variance

AUC:

Area under the curve

CECT:

Contrast-enhanced CT

CI:

Confidence interval

DCA:

Decision curve analysis

GLCM:

Gray level co-occurrence matrix

GLDM:

Gray level dependence matrix

GLRLM:

Gray level run length matrix

GLSZM:

Gray level size zone matrix

HPV:

Human papilloma virus

ICC:

Inter-/intra-class correlation coefficient

LASSO:

Least absolute shrinkage and selection operator

NGTDM:

Neighbouring gray tone difference matrix

NHL:

Non-Hodgkin’s lymphoma

Nomo-score:

Nomogram score

Rad-score:

Radiomics score

ROC:

Receiver operating characteristics

SCC:

Squamous cell carcinoma

SD:

Standard deviation

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Acknowledgements

We thank Karl Embleton, PhD, from Liwen Bianji, Edanz Group China (www.liwenbianji.cn/ac), for editing the English text of a draft of this manuscript.

Funding

This study has received funding from the Natural Science Foundation of Shandong Province (ZR2020MH286).

Author information

Author notes

  1. Cheng Dong and Ying-mei Zheng are collaborative first author. These two authors contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, The Affiliated Hospital of Qingdao University, NO. 16, Jiangsu Road, Qingdao, 266000, China

    Cheng Dong, Zeng-jie Wu, Zhi-tao Yang, Xiao-li Li, Wen-jian Xu & Da-peng Hao

  2. Health Management Center, The Affiliated Hospital of Qingdao University, NO. 16, Jiangsu Road, Qingdao, 266000, China

    Ying-mei Zheng

  3. Department of Radiology, The University of Hong Kong - Shenzhen Hospital, 1, Haiyuan Road, Futian District, Shenzhen, 518000, NO, China

    Jian Li

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  1. Cheng Dong
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Corresponding author

Correspondence to Da-peng Hao.

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Guarantor

The scientific guarantor of this publication is Da-peng Hao.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors (Jian Li) has significant statistical expertise.

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Written informed consent was obtained from all subjects (patients) in this study.

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Institutional review board approval was obtained.

Methodology

• Retrospective

• Diagnostic or prognostic study

• Multi-center study

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Dong, C., Zheng, Ym., Li, J. et al. A CT-based radiomics nomogram for differentiation of squamous cell carcinoma and non-Hodgkin’s lymphoma of the palatine tonsil. Eur Radiol 32, 243–253 (2022). https://doi.org/10.1007/s00330-021-08153-9

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  • DOI: https://doi.org/10.1007/s00330-021-08153-9

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