Deep learning radiomics nomogram predicts lymph node metastasis in laryngeal squamous cell carcinoma.

Background: Lymph node metastases (LNM) in laryngeal squamous cell carcinoma (LSCC) has been associated with lower survival, but current imaging methods, such as computed tomography (CT), have limited capabilities to identify them. Both conventional radiomics, involving data analysis of high-throughput quantitative features extracted from medical images, as well as deep learning networks, improved LNM diagnostic accuracy in LSCC, but the combination of both approaches has not been fully examined. In this study, we aimed to improve LNM identification in LSCC patients by developing a predictive nomogram, combining deep learning radiomics and clinical imaging features from CT images. Methods: A retrospective analysis of 235 LSCC patients, divided into training (164) and validation (71) sets, was conducted. Radiomics features were extracted from CT images, and 7 machine learning algorithms were used to develop 7 radiomics models, which were combined with deep learning features extracted from the ResNet50 deep learning network to form deep learning radiomics (DLR) models. The optimal DLR model was combined with significant clinical imaging features from CT scans to develop the predictive nomogram for LNM in LSCC. Results: The nomogram, under receiver operating characteristic (ROC) curve analyses, yielded areas under the curve (AUC) values of, respectively, 0.934 and 0.864 for training and validation sets, significantly higher than clinical imaging features (0.832 and 0.817), conventional radiomics (0.861 and 0.818), and DLR (0.913 and 0.864), indicating that it was significantly more accurate in predicting LNM in LSCC patients. Additionally, decision curve analysis found that the nomogram had significantly higher clinical utility than the other 3 models. Conclusion: The predictive nomogram, combining clinical imaging and DLR features, is able to accurately identify LNM in LSCC patients, providing valuable information for non-invasive LN staging and personalized treatment approaches.