Development and validation of an MRI-based radiomics nomogram for distinguishing Warthin's tumour from pleomorphic adenomas of the parotid gland.

Objective：: Preoperative differentiation between parotid Warthin's tumor (WT) and pleomorphic adenoma (PMA) is crucial for treatment decisions. The purpose of this study was to establish and validate an MRI-based radiomics nomogram for preoperative differentiation between WT and PMA.

Methods And Materials: A total of 127 patients with histological diagnosis of WT or PMA from two clinical centres were enrolled in training set ( = 75; WT = 34, PMA = 41) and external test set ( = 52; WT = 24, PMA = 28). Radiomics features were extracted from axial T1WI and fs-T2WI images. A radiomics signature was constructed, and a radiomics score (Rad-score) was calculated. A clinical factors model was built using demographics and MRI findings. A radiomics nomogram combining the independent clinical factors and Rad-score was constructed. The receiver operating characteristic analysis was used to assess the performance levels of the nomogram, radiomics signature and clinical model.

Results: The radiomics nomogram incorporating the age and radiomics signature showed favourable predictive value for differentiating parotid WT from PMA, with AUCs of 0.953 and 0.918 for the training set and test set, respectively.

Conclusions: The MRI-based radiomics nomogram had good performance in distinguishing parotid WT from PMA, which could optimize clinical decision-making.