A practical risk stratification system based on ultrasonography and clinical characteristics for predicting the malignancy of soft tissue masses.

IF 4.1 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Insights into Imaging Pub Date : 2024-09-19 DOI:10.1186/s13244-024-01802-9

Ying-Lun Zhang, Meng-Jie Wu, Yu Hu, Xiao-Jing Peng, Qian Ma, Cui-Lian Mao, Ye Dong, Zong-Kai Wei, Ying-Qian Gao, Qi-Yu Yao, Jing Yao, Xin-Hua Ye, Ju-Ming Li, Ao Li

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Abstract

Objective: To establish a practical risk stratification system (RSS) based on ultrasonography (US) and clinical characteristics for predicting soft tissue masses (STMs) malignancy.

Methods: This retrospective multicenter study included patients with STMs who underwent US and pathological examinations between April 2018 and April 2023. Chi-square tests and multivariable logistic regression analyses were performed to assess the association of US and clinical characteristics with the malignancy of STMs in the training set. The RSS was constructed based on the scores of risk factors and validated externally.

Results: The training and validation sets included 1027 STMs (mean age, 50.90 ± 16.64, 442 benign and 585 malignant) and 120 STMs (mean age, 51.93 ± 17.90, 69 benign and 51 malignant), respectively. The RSS was constructed based on three clinical characteristics (age, duration, and history of malignancy) and six US characteristics (size, shape, margin, echogenicity, bone invasion, and vascularity). STMs were assigned to six categories in the RSS, including no abnormal findings, benign, probably benign (fitted probabilities [FP] for malignancy: 0.001-0.008), low suspicion (FP: 0.008-0.365), moderate suspicion (FP: 0.189-0.911), and high suspicion (FP: 0.798-0.999) for malignancy. The RSS displayed good diagnostic performance in the training and validation sets with area under the receiver operating characteristic curve (AUC) values of 0.883 and 0.849, respectively.

Conclusion: The practical RSS based on US and clinical characteristics could be useful for predicting STM malignancy, thereby providing the benefit of timely treatment strategy management to STM patients.

Critical relevance statement: With the help of the RSS, better communication between radiologists and clinicians can be realized, thus facilitating tumor management.

Key points: There is no recognized grading system for STM management. A stratification system based on US and clinical features was built. The system realized great communication between radiologists and clinicians in tumor management.

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基于超声波和临床特征的实用风险分层系统，用于预测软组织肿块的恶性程度。

目的建立基于超声成像（US）和临床特征的实用风险分层系统（RSS），用于预测软组织肿块（STMs）的恶性程度：这项回顾性多中心研究纳入了2018年4月至2023年4月期间接受超声检查和病理检查的STMs患者。采用卡方检验和多变量逻辑回归分析来评估训练集中的US和临床特征与STM恶性程度的相关性。RSS是根据风险因素的评分构建的，并经过外部验证：训练集和验证集分别包括 1027 个 STM（平均年龄为 50.90 ± 16.64，良性 442 个，恶性 585 个）和 120 个 STM（平均年龄为 51.93 ± 17.90，良性 69 个，恶性 51 个）。RSS是根据三个临床特征（年龄、病程和恶性肿瘤史）和六个US特征（大小、形状、边缘、回声、骨侵犯和血管）构建的。STM在RSS中被分为六类，包括无异常发现、良性、可能良性（恶性的拟合概率[FP]：0.001-0.008）、低度怀疑（FP：0.008-0.365）、中度怀疑（FP：0.189-0.911）和高度怀疑（FP：0.798-0.999）恶性。在训练集和验证集中，RSS 显示出良好的诊断性能，接收器操作特征曲线下面积（AUC）值分别为 0.883 和 0.849：基于美国和临床特征的实用RSS可用于预测STM恶性肿瘤，从而为STM患者提供及时的治疗策略管理：在 RSS 的帮助下，放射科医生和临床医生之间可以更好地沟通，从而促进肿瘤管理：要点：目前尚无公认的 STM 管理分级系统。要点：目前尚无公认的 STM 管理分级系统。该系统实现了放射科医生和临床医生在肿瘤管理方面的良好沟通。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Insights into Imaging Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

7.30

自引率

4.30%

发文量

182

审稿时长

13 weeks

期刊介绍： Insights into Imaging (I³) is a peer-reviewed open access journal published under the brand SpringerOpen. All content published in the journal is freely available online to anyone, anywhere! I³ continuously updates scientific knowledge and progress in best-practice standards in radiology through the publication of original articles and state-of-the-art reviews and opinions, along with recommendations and statements from the leading radiological societies in Europe. Founded by the European Society of Radiology (ESR), I³ creates a platform for educational material, guidelines and recommendations, and a forum for topics of controversy. A balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes I³ an indispensable source for current information in this field. I³ is owned by the ESR, however authors retain copyright to their article according to the Creative Commons Attribution License (see Copyright and License Agreement). All articles can be read, redistributed and reused for free, as long as the author of the original work is cited properly. The open access fees (article-processing charges) for this journal are kindly sponsored by ESR for all Members. The journal went open access in 2012, which means that all articles published since then are freely available online.