Fu et al reported a nomogram for predicting the risk of malignancy in superficial lymphadenopathy. This can help to reduce unnecessary biopsies. The authors are from Peking University and Capital Medical University in Beijing.
Patient selection: superficial lymphadenopathy (neck, armpits, groin) = palpable areas
Parameters (based on Model 2):
(1) age in years, from 15 to 85
(2) known history of tumor
(3) long axis diameter in cm, from 0 to 5.5
(4) echogenic hilum
(5) blood flow distribution
(6) postvascular phase intensity in dB, from 0 to 160
points for age =
= (0.314 * (age)) - 4.714
points for long-axis diameter =
= 9.182 * (diameter)
points for postvascular phase =
= 100 - (0.625 * (intensity in dB))
|
Parameter
|
Finding
|
Points
|
|
known history of tumor
|
yes
|
21.6
|
|
|
no
|
0
|
|
echogenic hilum
|
absent
|
17.1
|
|
|
present
|
0
|
|
blood flow distribution
|
0 avascular
|
16.7
|
|
|
1 hilar
|
0
|
|
|
2 central
|
14.4
|
|
|
3 peripheral
|
20.5
|
|
|
4 mixed
|
20.1
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 231.7
• The higher the score the greater the risk of malignancy.
value of X =
= (0.0723 * (score)) - 10.25
risk of malignancy of superficial lymphadenopathy =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.92 in the training and 0.93 in the validation cohorts.
