A CT-Based Deep Learning Radiomics Nomogram to Predict Histological Grades of Head and Neck Squamous Cell Carcinoma

Published:November 30, 2022DOI:

      Rationale and Objectives

      Accurate pretreatment assessment of histological differentiation grade of head and neck squamous cell carcinoma (HNSCC) is crucial for prognosis evaluation. This study aimed to construct and validate a contrast-enhanced computed tomography (CECT)-based deep learning radiomics nomogram (DLRN) to predict histological differentiation grades of HNSCC.

      Materials and Methods

      A total of 204 patients with HNSCC who underwent CECT scans were enrolled in this study. The participants recruited from two hospitals were split into a training set (n=124, 74 well/moderately differentiated and 50 poorly differentiated) of patients from one hospital and an external test set of patients from the other hospital (n=80, 49 well/moderately differentiated and 31 poorly differentiated). CECT-based manually-extracted radiomics (MER) features and deep learning (DL) features were extracted and selected. The selected MER features and DL features were then combined to construct a DLRN via multivariate logistic regression. The predictive performance of the DLRN was assessed using ROCs and decision curve analysis (DCA).


      Three MER features and seven DL features were finally selected. The DLRN incorporating the selected MER and DL features showed good predictive value for the histological differentiation grades of HNSCC (well/moderately differentiated vs. poorly differentiated) in both the training (AUC, 0.878) and test (AUC, 0.822) sets. DCA demonstrated that the DLRN was clinically useful for predicting histological differentiation grades of HNSCC.


      A CECT-based DLRN was constructed to predict histological differentiation grades of HNSCC. The DLRN showed good predictive efficacy and might be useful for prognostic evaluation of patients with HNSCC.

      Key Words


      3D (Three-dimensional), AUC (Area under the curve), CECT (Contrast-enhanced CT), CI (Confidence interval), CNN (Convolutional neural network), DCA (Decision curve analysis), DICOM (Digital imaging and communications in medicine), DL (Deep learning), DLRN (Deep learning radiomics nomogram), GLCM (Gray level co-occurrence matrix), GLDM (Gray level dependence matrix), GLRLM (Gray level run length matrix), GLSZM (Gray level size zone matrix), HNSCC (Head and neck squamous cell carcinoma), HU (Hounsfield units), ICC (Inter-/intra- class correlation coefficient), LASSO (Least absolute shrinkage and selection operator), MER (Manually-extracted radiomics), NGTDM (Neighbouring gray tone difference matrix), PNG (Portable network graphics), ROC (Operating characteristics curve), ROI (Region of interest), SD (Standard deviation)
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