Hou Yiqing, Chen Chao, Zhang Lu, Zhou Wei, Lu Qinyang, Jia Xiaohong, Zhang Jingwen, Guo Cen, Qin Yuxiang, Zhu Lifeng, Zuo Ming, Xiao Jing, Huang Lingyun, Zhan Weiwei
Department of Ultrasound Diagnosis, Ruijin Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China.
Ping An Technology (Shenzhen) Co., Ltd., Shenzhen, China.
Front Oncol. 2021 Mar 16;11:614172. doi: 10.3389/fonc.2021.614172. eCollection 2021.
The aim of this study is to develop a model using Deep Neural Network (DNN) to diagnose thyroid nodules in patients with Hashimoto's Thyroiditis.
In this retrospective study, we included 2,932 patients with thyroid nodules who underwent thyroid ultrasonogram in our hospital from January 2017 to August 2019. 80% of them were included as training set and 20% as test set. Nodules suspected for malignancy underwent FNA or surgery for pathological results. Two DNN models were trained to diagnose thyroid nodules, and we chose the one with better performance. The features of nodules as well as parenchyma around nodules will be learned by the model to achieve better performance under diffused parenchyma. 10-fold cross-validation and an independent test set were used to evaluate the performance of the algorithm. The performance of the model was compared with that of the three groups of radiologists with clinical experience of <5 years, 5-10 years, >10 years respectively.
In total, 9,127 images were collected from 2,932 patients with 7,301 images for the training set and 1,806 for the test set. 56% of the patients enrolled had Hashimoto's Thyroiditis. The model achieved an AUC of 0.924 for distinguishing malignant and benign nodules in the test set. It showed similar performance under diffused thyroid parenchyma and normal parenchyma with sensitivity of 0.881 0.871 (p = 0.938) and specificity of 0.846 0.822 (p = 0.178). In patients with HT, the model achieved an AUC of 0.924 to differentiate malignant and benign nodules which was significantly higher than that of the three groups of radiologists (AUC = 0.824, 0.857, 0.863 respectively, p < 0.05).
The model showed high performance in diagnosing thyroid nodules under both normal and diffused parenchyma. In patients with Hashimoto's Thyroiditis, the model showed a better performance compared to radiologists with various years of experience.
本研究旨在开发一种使用深度神经网络(DNN)的模型来诊断桥本甲状腺炎患者的甲状腺结节。
在这项回顾性研究中,我们纳入了2932例2017年1月至2019年8月在我院接受甲状腺超声检查的甲状腺结节患者。其中80%被纳入训练集,20%作为测试集。疑似恶性的结节接受细针穿刺抽吸活检(FNA)或手术以获取病理结果。训练了两个DNN模型来诊断甲状腺结节,我们选择了性能更好的那个。模型将学习结节以及结节周围实质的特征,以在弥漫性实质情况下实现更好的性能。采用10折交叉验证和独立测试集来评估算法的性能。将该模型的性能与分别具有<5年、5 - 10年、>10年临床经验的三组放射科医生的性能进行比较。
总共从2932例患者中收集了9127张图像,其中7301张用于训练集,1806张用于测试集。纳入的患者中有56%患有桥本甲状腺炎。该模型在测试集中区分恶性和良性结节的曲线下面积(AUC)为0.924。在弥漫性甲状腺实质和正常实质情况下,其表现相似,敏感性分别为0.881和0.871(p = 0.938),特异性分别为0.846和0.822(p = 0.178)。在桥本甲状腺炎患者中,该模型区分恶性和良性结节的AUC为0.924,显著高于三组放射科医生(AUC分别为0.824、0.857、0.863,p < 0.05)。
该模型在正常和弥漫性实质情况下诊断甲状腺结节均表现出高性能。在桥本甲状腺炎患者中,与具有不同年限经验的放射科医生相比,该模型表现更佳。