基于计算机辅助超声诊断系统的甲状腺结节鉴别诊断及特征可视化：初步临床评估。

Differential diagnosis and feature visualization for thyroid nodules using computer-aided ultrasonic diagnosis system: initial clinical assessment.

机构信息

Department of Ultrasound, First Medical Center, Chinese PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing, 100853, China.

出版信息

BMC Med Imaging. 2022 Aug 30;22(1):153. doi: 10.1186/s12880-022-00874-7.

DOI:10.1186/s12880-022-00874-7

PMID:36042395

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9425995/

Abstract

BACKGROUND

To assess the diagnostic efficacy of the computer-aided ultrasonic diagnosis system (CAD system) in differentiating benign and malignant thyroid nodules.

METHODS

The images of 296 thyroid nodules were included in validation sets. The diagnostic efficacy of the CAD system was compared with that of junior physicians and senior physicians, as well as that of the combination diagnosis of the CAD system with junior physicians. The diagnostic efficacy of the CAD system for different sizes of thyroid nodules was compared.

RESULTS

The diagnostic sensitivity and accuracy of the CAD system were higher than those of junior physicians (83.4% vs. 72.2%, 73.0% vs. 69.6%), but the diagnostic specificity of the CAD system was lower than that of junior physicians (62.1% vs. 66.9%). The diagnostic accuracy of the CAD system was lower than that of senior physicians (73.0% vs. 83.8%). However, the combination diagnosis of the CAD system with junior physicians had higher accuracy (81.8%) and AUC (0.842) than those of either the CAD system or junior physicians alone, and comparable diagnostic performance with those of senior physicians. The Kappa was 0.635 in the combination diagnosis of the CAD system with junior physicians, showing good consistency with the pathological results. The accuracy (76.4%) of the CAD system was the highest for nodules of 1-2 cm.

CONCLUSION

The CAD system can effectively assist physicians to identify malignant and benign thyroid nodules, reduce the overdiagnosis and overtreatment of thyroid nodules, avoid unnecessary invasive fine needle aspiration, and improve the diagnostic accuracy of junior physicians.

摘要

背景

评估计算机辅助超声诊断系统（CAD 系统）在鉴别甲状腺良恶性结节中的诊断效能。

方法

将 296 个甲状腺结节的图像纳入验证集。比较 CAD 系统与初级医师和高级医师的诊断效能，以及 CAD 系统与初级医师联合诊断的诊断效能。比较 CAD 系统对不同大小甲状腺结节的诊断效能。

结果

CAD 系统的诊断灵敏度和准确性均高于初级医师（83.4%比 72.2%，73.0%比 69.6%），但特异性低于初级医师（62.1%比 66.9%）。CAD 系统的诊断准确性低于高级医师（73.0%比 83.8%）。然而，CAD 系统与初级医师联合诊断的准确性（81.8%）和 AUC（0.842）均高于 CAD 系统或初级医师单独诊断，且与高级医师的诊断性能相当。CAD 系统与初级医师联合诊断的 Kappa 值为 0.635，与病理结果具有较好的一致性。CAD 系统对 1-2cm 大小的结节的准确性（76.4%）最高。