Abstract
Objectives
To develop and compare several machine learning models to predict occult cervical lymph node (LN) metastasis in early-stage oral tongue squamous cell cancer (OTSCC) from preoperative MRI texture features.
Materials and methods
We retrospectively enrolled 116 patients with early-stage OTSCC (cT1-2N0) who had been surgically treated by tumor excision and elective neck dissection (END). For each patient, we extracted 86 texture features from T2-weighted imaging (T2WI) and contrast-enhanced T1-weighted imaging (ceT1WI), respectively. Dimension reduction was performed in three consecutive steps: reproducibility analysis, collinearity analysis, and information gain algorithm. Models were created using six machine learning methods, including logistic regression (LR), random forest (RF), naïve Bayes (NB), support vector machine (SVM), AdaBoost, and neural network (NN). Their performance was assessed using tenfold cross-validation.
Results
Occult LN metastasis was pathologically detected in 42.2% (49/116) of the patients. No significant association was identified between node status and patients’ gender, age, or clinical T stage. Dimension reduction steps selected 6 texture features. The NB model gave the best overall performance, which correctly classified the nodal status in 74.1% (86/116) of the carcinomas, with an AUC of 0.802.
Conclusion
Machine learning–based MRI texture analysis offers a feasible tool for preoperative prediction of occult cervical node metastasis in early-stage OTSCC.
Key Points
• A machine learning–based MRI texture analysis approach was adopted to predict occult cervical node metastasis in early-stage OTSCC with no evidence of node involvement on conventional images.
• Six texture features from T2WI and ceT1WI of preoperative MRI were selected to construct the predictive model.
• After comparing six machine learning methods, naïve Bayes (NB) achieved the best performance by correctly identifying the node status in 74.1% of the patients, using tenfold cross-validation.
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Abbreviations
- AUC:
-
Area under the curve
- ceT1WI:
-
Contrast-enhanced T1-weighted imaging
- DOI:
-
Depth of invasion
- END:
-
Elective neck dissection
- GLCM:
-
Gray-level co-occurrence matrix
- GLDM:
-
Gray-level dependence matrix
- GLRLM:
-
Gray-level run-length matrix
- GLSZM:
-
Gray-level size zone matrix
- HNSCC:
-
Head and neck squamous cell carcinoma
- ICCs:
-
Intraclass correlation coefficients
- LN:
-
Lymph node
- LR:
-
Logistic regression
- MRI:
-
Magnetic resonance imaging
- NB:
-
Naïve Bayes
- NN:
-
Neural network
- OTSCC:
-
Oral tongue squamous cell carcinoma
- RF:
-
Random forest
- ROC:
-
Receiver operator characteristic
- ROI:
-
Region of interests
- SVM:
-
Support vector machine
- T2WI:
-
T2-Weighted imaging
- TE:
-
Echo time
- TR:
-
Repetition time
- VOI:
-
Volume of interest
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Funding
This study has received funding by National Scientific Foundation of China (Grant number: 91859202, 81771901, to Xiaofeng Tao). Youth Medical Talents-Medical Imaging Practitioner Program (to Ying Yuan), Shanghai Municipal Health Commission (Grant number: 20194Y0104 to Jiliang Ren).
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The scientific guarantor of this publication is Xiaofeng Tao.
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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.
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• retrospective
• case-control study
• performed at one institution
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Yuan, Y., Ren, J. & Tao, X. Machine learning–based MRI texture analysis to predict occult lymph node metastasis in early-stage oral tongue squamous cell carcinoma. Eur Radiol 31, 6429–6437 (2021). https://doi.org/10.1007/s00330-021-07731-1
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DOI: https://doi.org/10.1007/s00330-021-07731-1