Multimodal MRI Deep Learning for Predicting Central Lymph Node Metastasis in Papillary Thyroid Cancer.

[BACKGROUND] Central lymph node metastasis (CLNM) in papillary thyroid cancer (PTC) significantly influences surgical decision-making strategies.

[OBJECTIVES] This study aims to develop a predictive model for CLNM in PTC patients using magnetic resonance imaging (MRI) and clinicopathological data.

[METHODS] By incorporating deep learning (DL) algorithms, the model seeks to address the challenges in diagnosing CLNM and reduce overtreatment. The results were compared with traditional machine learning (ML) models. In this retrospective study, preoperative MRI data from 105 PTC patients were divided into training and testing sets. A radiologist manually outlined the region of interest (ROI) on MRI images. Three classic ML algorithms (support vector machine [SVM], logistic regression [LR], and random forest [RF]) were employed across different data modalities. Additionally, an AMMCNet utilizing convolutional neural networks (CNNs) was proposed to develop DL models for CLNM. Predictive performance was evaluated using receiver operator characteristic (ROC) curve analysis, and clinical utility was assessed through decision curve analysis (DCA).

[RESULTS] Lesion diameter was identified as an independent risk factor for CLNM. Among ML models, the RF-(T1WI + T2WI, T1WI + T2WI + Clinical) models achieved the highest area under the curve (AUC) at 0.863. The DL fusion model surpassed all ML fusion models with an AUC of 0.891.

[CONCLUSIONS] A fusion model based on the AMMCNet architecture using MRI images and clinicopathological data was developed, effectively predicting CLNM in PTC patients.