Investigating the diagnostic efficiency of a computer-aided diagnosis system for thyroid nodules in the context of Hashimoto's thyroiditis.
Investigating the diagnostic efficiency of a computer-aided diagnosis system for thyroid nodules in the context of Hashimoto's thyroiditis.
复制标题
研究计算机辅助诊断系统对桥本甲状腺炎甲状腺结节的诊断效率
DOI：
10.3389/fonc.2022.941673
复制
发表时间：
2022
影响因子：
4.7
通讯作者：
Liu, Wen-Gang
中科院分区：
文献类型：
--
作者：
Gong, Liu;Zhou, Ping;Li, Jia-Le;Liu, Wen-Gang
本研究旨在探讨计算机辅助诊断（CAD）系统在区分桥本甲状腺炎（HT）背景下甲状腺结节的良性和恶性方面的有效性，并评估CAD系统在减少良性病变不必要活检中的作用。我们纳入了来自137名连续患者（平均年龄43.5 ± 11.8岁）的137个结节，这些患者均经组织病理学诊断为HT。所有甲状腺结节的二维超声图像和视频由CAD系统和两名具有不同经验的放射科医生根据ACR TI-RADS进行分析。将ACR TI-RADS的诊断截断值分为TR 4和TR 5两类，比较两种情况下CAD系统和初级、高级放射科医师的敏感性、特异性和受试者工作特征曲线下面积（AUC）。根据CAD系统的结果对ACR TI-RADS分级进行了修订，并通过比较不必要活检率和穿刺结节恶性率来评价推荐细针穿刺（FNA）的疗效。CAD系统的准确性、敏感性、特异性、PPV和NPV分别为0.876、0.905、0.830、0.894和0.846。以TR 4为界值，CAD系统和低、高级放射科医师的AUC分别为0.867、0.628和0.722，CAD系统的AUC最高（P < 0.0001）。以TR 5为界值，CAD系统与初级和高级放射科医师的AUC分别为0.867、0.654和0.812，CAD系统的AUC高于初级放射科医师（P < 0.0001），但与高级放射科医师相当（P = 0.0709）。在CAD系统的辅助下，无论是初级放射科医生还是高级放射科医生，TR 4结节的数量都减少了，穿刺结节的恶性率分别提高了30%和22%，而良性病变的不必要活检均减少了近一半。基于深度学习的CAD系统可以提高放射科医生在桥本甲状腺炎背景下识别良性和恶性甲状腺结节的诊断性能，并可以在FNA建议中发挥作用，以减少不必要的活检率。
This study aims to investigate the efficacy of a computer-aided diagnosis (CAD) system in distinguishing between benign and malignant thyroid nodules in the context of Hashimoto’s thyroiditis (HT) and to evaluate the role of the CAD system in reducing unnecessary biopsies of benign lesions. We included a total of 137 nodules from 137 consecutive patients (mean age, 43.5 ± 11.8 years) who were histopathologically diagnosed with HT. The two-dimensional ultrasound images and videos of all thyroid nodules were analyzed by the CAD system and two radiologists with different experiences according to ACR TI-RADS. The diagnostic cutoff values of ACR TI-RADS were divided into two categories (TR4 and TR5), and then the sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) of the CAD system and the junior and senior radiologists were compared in both cases. Moreover, ACR TI-RADS classification was revised according to the results of the CAD system, and the efficacy of recommended fine-needle aspiration (FNA) was evaluated by comparing the unnecessary biopsy rate and the malignant rate of punctured nodules. The accuracy, sensitivity, specificity, PPV, and NPV of the CAD system were 0.876, 0.905, 0.830, 0.894, and 0.846, respectively. With TR4 as the cutoff value, the AUCs of the CAD system and the junior and senior radiologists were 0.867, 0.628, and 0.722, respectively, and the CAD system had the highest AUC (P < 0.0001). With TR5 as the cutoff value, the AUCs of the CAD system and the junior and senior radiologists were 0.867, 0.654, and 0.812, respectively, and the CAD system had a higher AUC than the junior radiologist (P < 0.0001) but comparable to the senior radiologist (P = 0.0709). With the assistance of the CAD system, the number of TR4 nodules was decreased by both junior and senior radiologists, the malignant rate of punctured nodules increased by 30% and 22%, and the unnecessary biopsies of benign lesions were both reduced by nearly half. The CAD system based on deep learning can improve the diagnostic performance of radiologists in identifying benign and malignant thyroid nodules in the context of Hashimoto’s thyroiditis and can play a role in FNA recommendations to reduce unnecessary biopsy rates.
登录
查看更多内容
影响因子：
4.7
作者：
Liang X;Huang Y;Cai Y;Liao J;Chen Z
通讯作者：
Chen Z
影响因子：
4.7
作者：
Hou Y;Chen C;Zhang L;Zhou W;Lu Q;Jia X;Zhang J;Guo C;Qin Y;Zhu L;Zuo M;Xiao J;Huang L;Zhan W
通讯作者：
Zhan W
影响因子：
4.2
作者：
Hu, Fengqiu;Yan, Zhe;Huang, Hui
通讯作者：
Huang, Hui
影响因子：
1.7
作者：
Trovato, Maria;Giuffrida, Giuseppe;Seminara, Antonino;Fogliani, Simone;Cavallari, Vittorio;Ruggeri, Rosaria Maddalena;Campennì, Alfredo
通讯作者：
Campennì, Alfredo
影响因子：
4.6
作者：
Kang S;Lee E;Chung CW;Jang HN;Moon JH;Shin Y;Kim K;Li Y;Shin SM;Kim YH;Kwon SK;Ahn CH;Jung KY;Hong AR;Park YJ;Park DJ;Kwak JY;Cho SW
通讯作者：
Cho SW