{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T04:50:55Z","timestamp":1768625455778,"version":"3.49.0"},"reference-count":36,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T00:00:00Z","timestamp":1748304000000},"content-version":"vor","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100018532","name":"Major Scientific and Technological Innovation Project of Shandong Province","doi-asserted-by":"publisher","award":["2019JZZY021002"],"award-info":[{"award-number":["2019JZZY021002"]}],"id":[{"id":"10.13039\/501100018532","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Thoracic Cancer"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Lymph node metastasis (<jats:styled-content style=\"fixed-case\">LNM<\/jats:styled-content>) poses a considerable threat to survival in lung adenocarcinoma. Currently, minor resection is the recommended surgical approach for small\u2010diameter lung cancer. The accurate preoperative identification of <jats:styled-content style=\"fixed-case\">LNM<\/jats:styled-content> in patients with small\u2010diameter lung cancer is important for improving patient survival and outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 1740 patients with clinical early\u2010stage lung adenocarcinoma who underwent surgical resection were enrolled in this study. The Lasso model was used to screen clinical and imaging features, and multivariate logistic regression analysis was used to analyze the relevant diagnostic factors to establish a diagnostic model for predicting <jats:styled-content style=\"fixed-case\">LNM<\/jats:styled-content>. Receiver operating characteristic (<jats:styled-content style=\"fixed-case\">ROC<\/jats:styled-content>) curve analysis, decision curve analysis (<jats:styled-content style=\"fixed-case\">DCA<\/jats:styled-content>) and calibration curve analysis were used to verify the clinical efficacy of the model, which was further validated with an internal validation set.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The proportion of solid components (<jats:styled-content style=\"fixed-case\">PSC<\/jats:styled-content>), sphericity, nodule margin, entropy, and edge blur were identified as diagnostic factors that were strongly correlated with <jats:styled-content style=\"fixed-case\">LNM<\/jats:styled-content> in lung adenocarcinoma patients. The area under the <jats:styled-content style=\"fixed-case\">ROC<\/jats:styled-content> curve (<jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content>) in the internal training set was 0.91. Decision curve analysis revealed that the model could achieve greater benefits for patients. The calibration curve was used to further verify the applicability of the prediction model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with early\u2010stage lung adenocarcinoma with <jats:styled-content style=\"fixed-case\">LNM<\/jats:styled-content> can be identified by typical imaging features. The diagnostic model can help to optimize surgical planning among thoracic surgeons.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1759-7714.70048","type":"journal-article","created":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T02:59:40Z","timestamp":1748401180000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Image\u2010Based Deep Learning Model for Predicting Lymph Node Metastasis in Lung Adenocarcinoma With <scp>CT \u2264<\/scp>\u20092\u2009<scp>cm<\/scp>"],"prefix":"10.1111","volume":"16","author":[{"given":"Shang","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University Shandong First Medical University  Jinan People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhen","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, 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