基于超声的计算机辅助诊断在不同放射科医生对细胞学不确定的甲状腺结节的应用。

Ultrasound-based computer-aided diagnosis for cytologically indeterminate thyroid nodules with different radiologists.

机构信息

Department of Medical Ultrasound, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.

Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China.

出版信息

Clin Hemorheol Microcirc. 2022;82(3):217-230. doi: 10.3233/CH-221423.

DOI:10.3233/CH-221423

PMID:35848013

Abstract

PURPOSE

To evaluate a computer-aided diagnosis (CAD) technique in predicting malignancy for cytologically indeterminate thyroid nodules (TNs) as compared with different experienced radiologists.

METHOD

436 patients with 436 cytologically indeterminate TNs on fine-needle aspiration cytology (FNAC) were included and all were confirmed by surgical pathology. They were retrospectively analyzed with respect to ultrasound (US) characteristics using a commercially available CAD system (AmCAD-UT; AmCad BioMed, Taiwan, China) and reviewed by one junior and one senior radiologists.The CAD system and different experienced radiologists stratified the risk of malignancy using ACR TI-RADS category. The diagnostic performance by different experienced radiologists independently and after consulting the CAD (different experienced radiologists + CAD) and by the CAD alone were compared.

RESULTS

The different experienced radiologists showed significantly higher specificities than the CAD system alone. The combination of radiologist and CAD system showed improved diagnostic performance with an AUC (Area under the curve) of 0.740 in the senior radiologist and 0.677 in the junior radiologist, as compared with CAD (AUC: 0.585) alone (all P < 0.05). The combination of senior radiologist and CAD system had the highest diagnostic performance (AUC: 0.740) and specificity (68.9%) compared to the others (all P < 0.05).

CONCLUSION

The CAD system may play the potential role as a decision-making assistant alongside radiologists for differential diagnosis of TNs with indeterminate cytology.

摘要

目的

与不同经验的放射科医生相比，评估计算机辅助诊断（CAD）技术在预测细胞学不确定甲状腺结节（TNs）恶性肿瘤方面的作用。

方法

共纳入 436 例经细针穿刺细胞学（FNAC）检查为细胞学不确定的 TNs 患者，所有患者均经手术病理证实。回顾性分析其超声（US）特征，使用商业 CAD 系统（AmCAD-UT；中国台湾 AmCad BioMed），由一名初级放射科医生和一名高级放射科医生进行评估。CAD 系统和不同经验的放射科医生根据 ACR TI-RADS 分类，对恶性肿瘤风险进行分层。比较不同经验的放射科医生独立、咨询 CAD 后（不同经验的放射科医生+CAD）以及仅 CAD 的诊断性能。

结果

不同经验的放射科医生的特异性明显高于 CAD 系统。与单独使用 CAD 系统相比，放射科医生和 CAD 系统的结合显示出了更好的诊断性能，高级放射科医生的 AUC（曲线下面积）为 0.740，初级放射科医生为 0.677，而 CAD 系统单独使用时的 AUC 为 0.585（均 P<0.05）。与其他方法相比，高级放射科医生和 CAD 系统的组合具有最高的诊断性能（AUC：0.740）和特异性（68.9%）（均 P<0.05）。