Objective To construct a predictive model for postoperative recurrence and metastasis of thyroid cancer(TC)based on positron emission computed tomography(PET-CT)and contrast-enhanced ultrasound parameters.Meth-ods A total of 116 patients with TC who underwent surgical treatment in our hospital from January 2018 to March 2021 were retrospectively selected.All patients underwent PET-CT and contrast-enhanced ultrasound before operation,and the clinical data of the patients were collected.The patients were followed up for 3 years after operation,and they were divided into the occurrence group(32 cases)and the non-occurrence group(84 cases)according to whether recur-rence and metastasis occurred during the follow-up period.The influencing factors of postoperative recurrence and me-tastasis were analyzed by multivariate stepwise Logistic regression model.A nomogram prediction model was construc-ted based on PET-CT and CEUS parameters.The area under the receiver operating characteristic(ROC)curve(AUC)was used to analyze the predictive efficacy of the model for postoperative recurrence and metastasis.Results The maxi-mum standardized uptake value(SUVmax)in the occurrence group were higher than those in the non-occurrence group,and the time to peak(TTP),peak intensity(PI)was lower than that in the non-occurrence group(P＜0.05).The pro-portion of patients with clinical stage Ⅲ/Ⅳ and lymph node metastasis in the occurrence group was higher than that in the non-occurrence group,and the proportion of postoperative 131 iodine treatment was lower than that in the non-oc-currence group(P＜0.05).Multivariate stepwise Logistic regression analysis showed that SUVmax level(OR=4.631,95％CI:2.077～10.323),clinical stage(OR=5.427,95％CI:2.653～11.098)were independent risk factors for postop-erative recurrence and metastasis,and PI level(OR=0.254,95％CI:0.136～0.471),postoperative 131I treatment(OR=0.306,95％CI:0.110～0.849)were independent protective factors(P＜0.05).The nomogram prediction model based on the above influencing factors was internally verified by the Bootstrap method,and the C-index was 0.836(95％CI:0.734～0.938).The calibration curve for predicting postoperative recurrence and metastasis was close to the ideal curve(P＞0.05).The ROC curve showed that the sensitivity of the nomogram model for predicting postoperative recur-rence and metastasis was 87.50％,the specificity was 88.10％,and the AUC was 0.881(95％CI:0.794～0.968)(P＜0.05).Conclusion The nomogram prediction model based on PET-CT parameter SUVmax and CEUS parameter PI can better predict the risk of postoperative recurrence and metastasis in TC patients.
Thyroid cancerPostoperative recurrence and metastasisPositron emission computed tomographyCon-trast-enhanced ultrasoundPrediction model
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