Hu Minxia, Zong Suting, Xu Ning, Li Jinzhen, Xia Chunxia, Yu Fengxia, Zhu Qiang, Zhao Hanxue
Department of Diagnostic Ultrasound, Beijing Tongren Hospital, Capital Medical University, Beijing, PR China.
J Ultrasound Med. 2022 May;41(5):1117-1124. doi: 10.1002/jum.15801. Epub 2021 Aug 12.
To investigate the value of computer-aided diagnosis (CAD) system in assessing thyroid nodules concurrent with Hashimoto's thyroiditis (HT).
Totally 148 patients with 193 thyroid nodules were enrolled. A radiologist assessed the nodules using a thyroid ultrasound CAD system. Additionally, the nodules were evaluated by one experienced radiologist alone, and one training radiologist without and with CAD assistance. The diagnostic performance was compared between the CAD system and the experienced radiologist, and the training radiologist without and with CAD assistance.
The CAD system demonstrated a similar sensitivity to that of the experienced radiologist in diagnosing thyroid cancers (89.8% versus 92.4%, P > .05). The specificity and accuracy of the CAD system were lower than that of the experienced radiologist in assessing the nodules with diffusedly altered glands (specificity, 60.0% versus 81.7%, P = .007; accuracy, 77.5% versus 88.1%, P = .011). With CAD assistance, the training radiologist had improved sensitivity and accuracy that increased to 87.9% and 86.8% in classifying nodules with sonographically evident HT (both P = .012).
The CAD system has comparable sensitivity, but lower specificity compared with the experienced radiologist in diagnosing thyroid malignancies concurrent with HT. For a radiologist with less experience, the CAD system can help improve the diagnostic performance by increasing sensitivity and accuracy in assessing thyroid nodules with diffusely altered parenchyma.
探讨计算机辅助诊断(CAD)系统在评估合并桥本甲状腺炎(HT)的甲状腺结节中的价值。
共纳入148例患者的193个甲状腺结节。一名放射科医生使用甲状腺超声CAD系统对结节进行评估。此外,分别由一名经验丰富的放射科医生单独评估结节,以及一名未借助和借助CAD辅助的实习放射科医生评估结节。比较CAD系统与经验丰富的放射科医生以及未借助和借助CAD辅助的实习放射科医生之间的诊断性能。
CAD系统在诊断甲状腺癌方面的敏感性与经验丰富的放射科医生相似(89.8%对92.4%,P>0.05)。在评估腺体弥漫性改变的结节时,CAD系统的特异性和准确性低于经验丰富的放射科医生(特异性,60.0%对81.7%,P = 0.007;准确性,77.5%对88.1%,P = 0.011)。在CAD辅助下,实习放射科医生在对超声表现明显的HT结节进行分类时,敏感性和准确性有所提高,分别提高到87.9%和86.8%(P均 = 0.012)。
在诊断合并HT的甲状腺恶性肿瘤时,CAD系统具有相当的敏感性,但与经验丰富的放射科医生相比特异性较低。对于经验较少的放射科医生,CAD系统可通过提高评估实质弥漫性改变的甲状腺结节的敏感性和准确性来帮助改善诊断性能。