Application Study Of Computer-aided Ultrasound Diagnosis System For Thyroid Nodules

ObjectiveThe aim of this study was to evaluate the diagnostic value of computer aided diagnosis(CAD)system for thyroid nodules by analysing sonographic imaging data and improvements in diagnostic performance according to radiologists experience.MethodsWe retrospectively collected sonographic images and pathological data of thyroid nodules.465 ultrasound images of 275 thyroid nodules(benign/malignant:99/176)from 218 patients in Peking union medical college hospital from February 2018 to June 2018 and 288 ultrasound images of 120 thyroid nodules(benign/malignant:41/79)from 113 patients in China-Japan friendship hospital from July 2019 to January 2020 were included.Sonographic images were input into the CAD system for automatic identification and diagnosis of thyroid nodules which was established based on RetinaNet.The CAD system and four radiologists(2 inexperienced radiologists and 2 experienced radiologists),provided a diagnosis(benign or malignant)for each thyroid nodule.The radiologists provided a diagnosis first without CAD system,then again after being informed of the CAD system results.We compared the diagnostic performance of the CAD system,four radiologists without and with the CAD system.ResultsThe sensitivity,specificity,accuracy and the area under the receiver operating characteristic curve(AUROC)of the CAD system were 94.12%,60.71%,82.28%and 0.774(0.721-0.828)for whole validation set,respectively.Compared with inexperienced radiologists,the sensitivity and AUROC of the CAD system in the diagnosis of thyroid cancer were significantly higher,and the specificity was significantly higher than that of one of them.Compared with experienced radiologists,the sensitivity had no statistically significant difference,and the specificity and AUROC of the CAD system were significantly lower than that of one experienced radiologists,and higher than that of another.Combining with CAD system,the sensitivity and AUROC of inexperienced radiologists were significantly increased and the specificity was significantly increased in one of them.The diagnosis effect of experienced radiologists were not improved significantly.ConclusionCAD system has a high accuracy in the identification of thyroid cancer,which is comparable with that of experienced radiologists,and can significantly improve the diagnostic ability of inexperienced radiologists.ObjectiveTo study the reproducibility and diagnostic effect of SWE in the diagnosis of thyroid nodules and diagnostic value of CAD combining with SWE.Methods80 thyroid nodules(malignant/benign:57/23)of 47 inpatients(male/female:18/29)in Peking Union Medical College Hospital from September to December 2017 were included.On the day before thyroidectomy,1 gray-scale ultrasound image and 3 SWE images on transverse/longitudinal section of each thyroid nodule were collected.Gray-scale ultrasound images were input into the CAD system,and the benign or malignant were obtained.We used the Q-Box TM Ratio function to measure each SWE images to obtain the Young’s modulus including:ratio-E-Ratio,the average Young’s modulus-Emean,the minimum Young’s modulus-Emin,the maximum Yang’s modulus-Emax.41 nodules were selected for comparing intra-observer and inter-observer agreement of SWE.Using the pathological results as the gold standard,draw the receiver operating characteristic curve to obtain the cut-off value of the Young’s modulus.Comparing the diagnostic value of SWE,CAD system and combination of CAD system and SWE.ResultThe measurements of Emean,Emin,Emax measured in the transverse/longitudinal section of intra-observer and inter-observer reached excellent consistency,and The measurments of E-Ratio reached average to excellent consistency.The cut-off values of E-Ratio,Emean,Emin,and Emax for the diagnosis of thyroid cancer were 1.85,30.95 kPa,20.85 kPa,and 42.70 kPa,respectively.The sensitivity,specificity,accuracy and AUROC of Emax were 40.35%、91.30%、55.00%,0.677(0.555-0.799).Compared with the CAD system,the sensitivity of Emax was lower(89.47%vs.40.35%,P<0.001),the specificity of Emax was higher(65.22%vs.91.30%,P=0.114).Compared with the CAD system,the sensitivity of combination of the CAD system and SWE increased and the specificity decreased,but the differences were not statistically significant.Conclusion SWE can identify benign and malignant thyroid nodules,but its value is limited.The combination of CAD and SWE cannot significantly improve the diagnostic ability of CAD system.