AUTHOR=Liu Xiaoling , Xiao Weihan , Yang Chen , Wang Zhihua , Tian Dong , Wang Gang , Qin Xiachuan 

TITLE=Diagnosis of parotid gland tumors using a ternary classification model based on ultrasound radiomics

JOURNAL=Frontiers in Oncology

VOLUME=Volume 15 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2025.1485393

DOI=10.3389/fonc.2025.1485393

ISSN=2234-943X

ABSTRACT=ObjectiveThis study aimed to evaluate the diagnostic value of two-step ultrasound radiomics models in distinguishing parotid malignancies from pleomorphic adenomas (PAs) and Warthin’s tumors (WTs).MethodsA retrospective analysis was conducted on patients who underwent parotidectomy at our institution between January 2015 and December 2022. Radiomics features were extracted from two-dimensional (2D) ultrasound images using 3D Slicer. Feature selection was performed using the Mann–Whitney U test and seven additional selection methods. Two-step LASSO-BNB and voting ensemble learning modeling algorithm with recursive feature elimination feature selection method (RFE-Voting) models were then applied for classification. Model performance was assessed using the area under the receiver operating characteristic curve (AUC), and internal validation was conducted through fivefold cross-validation.ResultsA total of 336 patients were included in the study, comprising 73 with malignant tumors and 263 with benign lesions (118 WT and 145 PA). The LASSO-NB model demonstrated excellent performance in distinguishing between benign and malignant parotid lesions, achieving an AUC of 0.910 (95% CI, 0.907–0.914), with an accuracy of 86.8%, sensitivity of 92.5%, and specificity of 66.7%, significantly outperforming experienced sonographers (accuracy of 61.90%). The RFE-Voting model also showed outstanding performance in differentiating PA from WT, with an AUC of 0.962 (95% CI, 0.959–0.963), accuracy of 83.0%, sensitivity of 84.0%, and specificity of 92.1%, exceeding the diagnostic capability of experienced sonographers (accuracy of 65.39%).ConclusionThe two-step LASSO-BNB and RFE-Voting models based on ultrasound imaging performed well in distinguishing glandular malignant tumors from PA and WT and have good predictive capabilities, which can provide more useful information for non-invasive differentiation of parotid gland tumors before surgery.