Development and Internal Validation of a Nomogram Model Discriminating Liver Metastases of Melanoma From Other Common Liver Metastases Based on the Combination of Conventional Ultrasonography and Contrast-enhanced Ultrasonography.

Authors

Yuanyuan Xu, Hao Wu, Haijing Tian, Hewen Tang, Yue Cong, Shanshan Yin, Wei Yang, Kun Yan, Wei Wu

Published in

Academic radiology. Jul 11, 2026. Epub Jul 11, 2026.

Abstract

By comparing conventional ultrasonography (US) and contrast-enhanced ultrasonography (CEUS) features of liver metastases of melanoma (LMM) with those of other common liver metastases from non-melanoma malignancies (non-LMM), a differential diagnosis nomogram was developed and internally validated to explore its clinical application value.
This single-center, retrospective, case-control study enrolled 108 patients with LMM (109 lesions) and 95 patients with non-LMM (109 lesions) at our institution from January 2017 to April 2025. All cases were confirmed by pathological diagnosis. Univariate analysis was performed to compare clinical characteristics and US/CEUS features between groups. Variables with P < 0.05 were entered into a stepwise bidirectional regression model (based on the Akaike information criterion (AIC)) to identify independent risk factors and assess collinearity (using variance inflation factor (VIF)). A nomogram was developed using logistic regression and generalized estimating equations (GEE) and evaluated by the area under the receiver operating characteristic curve (AUC-ROC), bootstrapping (1000 resamples), calibration curves, and decision curve analysis (DCA).
The independent risk factors included in the nomogram model were morphology, posterior acoustic enhancement, number, enhancement pattern and wash-out time. The model demonstrated an AUC of 0.892 (95% CI: 0.849-0.935) and a bias-corrected AUC of 0.873 (95% CI: 0.805-0.933) by bootstrapping. Both calibration curves and DCA demonstrated the nomogram's favorable calibration and clinical utility (Hosmer-Lemeshow test, P > 0.05).
The LMM differential diagnosis nomogram based on US/CEUS features complements clinical screening and facilitates precise diagnosis while aiding in subsequent treatment evaluation and follow-up.

PMID:
42436059
Bibliographic data and abstract were imported from PubMed on 12 Jul 2026.

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