Patients with papillary thyroid carcinoma (PTC) would benefit from risk stratification tools that can aid in planning personalized treatment and follow-up. The aim of this study was to develop a conventional ultrasound (US)-based radiomics signature to estimate disease-free survival (DFS) in patients with conventional PTC. Imaging features were extracted from the pretreatment US images of 768 patients with conventional PTC who were treated between January 2004 and February 2006. The median follow-up period was 117.3 months, with 85 (11.1%) events. A radiomics signature (Rad-score) was generated by using the least absolute shrinkage and selection operator (LASSO) method in Cox regression. The Rad-score was significantly associated with DFS (hazard ratio [HR], 3.087; P < 0.001), independent of clinicopathologic risk factors. A radiomics model which incorporated the Rad-score demonstrated better performance in the estimation of DFS (C-index: 0.777; 95% confidence interval [CI]: 0.735, 0.829) than the clinicopathologic model (C-index: 0.721; 95% CI: 0.675, 0.780). In conclusion, radiomics features from pretreatment US may be potential imaging biomarkers for risk stratification in patients with conventional PTC.
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