Evidence map›Paper›PMID 40097945›Full record

ArticleBMC medical imaging2025

A Stepwise decision tree model for differential diagnosis of Kimura's disease in the head and neck.

Rui Luo, Gongxin Yang, Huimin Shi, Yining He, Yongshun Han, Zhen Tian, Yingwei Wu

Abstract read
In one paragraph

Article in BMC medical imaging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. A Comprehensive Review of Kimura Disease.Head and neck pathology · 2025
    Pooled it
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Rui Luo *Department of Radiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
Gongxin Yang *Department of Radiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
Huimin ShiDepartment of Radiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
Yining HeDepartment of Statistics, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
Yongshun HanDepartment of Radiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
Zhen TianDepartment of Oral Pathology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
Yingwei WuDepartment of Radiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China. wuyw0103@hotmail.com.

Funding

Cross Disciplinary Research Fund of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine JYJC202107National Natural Science Foundation of China 82373114
6 · The paper itself

Abstract

objectivesThis study aims to differentiate Kimura's disease (KD) from Sjogren's syndrome with mucosa-associated lymphoid tissue lymphoma (SS&MALT), neurofibromatosis (NF), and lymphoma in the head and neck by using a stepwise decision tree approach. MATERIALS AND

methodsA retrospective analysis of 202 patients with pathologically confirmed KD, SS&MALT, NF, or lymphoma was conducted. Demographic and magnetic resonance imaging (MRI) data were collected, with qualitative features (e.g., skin thickening, lesion morphology, lymphadenopathy, MRI signal intensity) and quantitative variables (e.g., age, lesion size, apparent diffusion coefficients (ADCs), wash-in rate, time to peak (TTP), time-signal intensity curve (TIC) patterns) examined. A stepwise decision-tree model using the classification and regression trees (CART) algorithm was developed to aid in the differential diagnosis of KD in the head and neck. The model's diagnostic accuracy and misclassification risk were assessed to evaluate its reliability and effectiveness.

resultsKey characteristics for KD included male predominance (91.7%), frequent lymphadenopathy (86.1%), and skin thickening (72.2%). Primary lesions of NF typically exhibited higher ADCs compared to those of KD, SS&MALT, and lymphoma. In lymphadenopathy, however, unique ADC patterns were observed: in KD, the ADCs of lymphadenopathy were lower than those of primary lesions, whereas in lymphoma, the ADCs of lymphadenopathy were comparable to those of primary lesions. Predictors for distinguishing KD included lesion's location, ADCs, lymphadenopathy, and sizes (all p < 0.001). The decision-tree model achieved an impressive 99.0% accuracy in the differential diagnosis across the overall cohort, with a 10-fold cross-validated misclassification risk of 0.079 ± 0.024.

conclusionThe stepwise decision tree model, based on MRI features, showed high accuracy in differentiating KD from other head and neck diseases, offering a reliable diagnostic tool in clinical practice. CLINICAL RELEVANCE: KD is characterized by male predominance, skin thickening, and high incidence of lymphadenopathy. ADCs and TIC patterns are distinguishable in differentiating KD from SS&MALT, NF, and lymphoma in the head and neck. The decision tree model enhances the understanding of KD imaging features and facilitates accurate KD diagnosis, offering an easily accessible and convenient diagnostic tool for radiologists and physicians in daily practice and guiding tailored clinical management plans for affected patients. CLINICAL TRIAL NUMBER: Not applicable.

Indexed as

Decision TreesKimura DiseaseMagnetic Resonance ImagingAdolescentAdultAgedDiagnosis, DifferentialFemaleHeadHead and Neck NeoplasmsHumansLymphomaLymphoma, B-Cell, Marginal ZoneMaleMiddle AgedNeckDecision treeHead and neck diseasesKDLymphadenopathyMRI

Identifiers

PMID40097945
PMCPMC11916975

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.