TY - JOUR
T1 - A computer-aided diagnosis system for the assessment and characterization of low-to-high suspicion thyroid nodules on ultrasound
AU - Gitto, Salvatore
AU - Grassi, Giorgia
AU - De Angelis, Chiara
AU - Monaco, Cristian Giuseppe
AU - Sdao, Silvana
AU - Sardanelli, Francesco
AU - Sconfienza, Luca Maria
AU - Mauri, Giovanni
PY - 2019
Y1 - 2019
N2 - Aim of the study: To compare the diagnostic performance of a commercially available computer-aided diagnosis (CAD) system for thyroid ultrasound (US) with that of a non-computer-aided radiologist in the characterization of low-to-high suspicion thyroid nodules. Methods: This retrospective study included a consecutive series of adult patients referred for US-guided fine-needle aspiration biopsy (FNAB) of a thyroid nodule. All patients were eligible for thyroid nodule FNAB according to the current international guidelines. An interventional radiologist experienced in thyroid imaging acquired the US images subsequently used for post-processing, performed FNAB and provided the US features of each nodule. A radiology resident and an endocrinology resident in consensus performed post-processing using the CAD system to assess the same nodule characteristics. The diagnostic performance and agreement of US features between the CAD system and the radiologist were compared. Results: Sixty-two patients (50 F; age 60 ± 12 years) were enrolled: 77.4% (48/62) of thyroid nodules were benign, 22.6% (14/62) were undetermined to malignant and required follow-up or surgery. Interobserver agreement between the CAD system and the radiologist was substantial for orientation (K = 0.69), fair for composition (K = 0.36), echogenicity (K = 0.36), K-TIRADS (K = 0.29), and slight for margins (K = 0.03). The radiologist demonstrated a significantly higher sensitivity than the CAD system (78.6% vs. 21.4%; P = 0.008), while there was no statistical difference in specificity (66.7% vs. 81.3%; P = 0.065). Conclusion: This CAD system is less sensitive than an experienced radiologist and showed slight-to-substantial agreement with the radiologist for the characterization of thyroid nodules. Although it is an innovative tool with good potential, additional efforts are needed to improve its diagnostic performance.
AB - Aim of the study: To compare the diagnostic performance of a commercially available computer-aided diagnosis (CAD) system for thyroid ultrasound (US) with that of a non-computer-aided radiologist in the characterization of low-to-high suspicion thyroid nodules. Methods: This retrospective study included a consecutive series of adult patients referred for US-guided fine-needle aspiration biopsy (FNAB) of a thyroid nodule. All patients were eligible for thyroid nodule FNAB according to the current international guidelines. An interventional radiologist experienced in thyroid imaging acquired the US images subsequently used for post-processing, performed FNAB and provided the US features of each nodule. A radiology resident and an endocrinology resident in consensus performed post-processing using the CAD system to assess the same nodule characteristics. The diagnostic performance and agreement of US features between the CAD system and the radiologist were compared. Results: Sixty-two patients (50 F; age 60 ± 12 years) were enrolled: 77.4% (48/62) of thyroid nodules were benign, 22.6% (14/62) were undetermined to malignant and required follow-up or surgery. Interobserver agreement between the CAD system and the radiologist was substantial for orientation (K = 0.69), fair for composition (K = 0.36), echogenicity (K = 0.36), K-TIRADS (K = 0.29), and slight for margins (K = 0.03). The radiologist demonstrated a significantly higher sensitivity than the CAD system (78.6% vs. 21.4%; P = 0.008), while there was no statistical difference in specificity (66.7% vs. 81.3%; P = 0.065). Conclusion: This CAD system is less sensitive than an experienced radiologist and showed slight-to-substantial agreement with the radiologist for the characterization of thyroid nodules. Although it is an innovative tool with good potential, additional efforts are needed to improve its diagnostic performance.
KW - Computer-aided diagnosis
KW - Nodule
KW - Thyroid
KW - Ultrasound
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U2 - 10.1007/s11547-018-0942-z
DO - 10.1007/s11547-018-0942-z
M3 - Article
AN - SCOPUS:85053761207
VL - 124
SP - 118
EP - 125
JO - Radiologia Medica
JF - Radiologia Medica
SN - 0033-8362
IS - 2
ER -