Xu Chen, Wang Zuxin, Zhou Jun, Hu Fan, Wang Ying, Xu Zhongqing, Cai Yong
Public Health Research Center, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China.
Project Department, Tend.AI Medical Technologies Co., Shanghai, P.R. China.
PLoS One. 2025 Jun 2;20(6):e0323343. doi: 10.1371/journal.pone.0323343. eCollection 2025.
Thyroid nodule, as a common clinical endocrine disease, has become increasingly prevalent worldwide. Ultrasound, as the premier method of thyroid imaging, plays an important role in accurately diagnosing and managing thyroid nodules. However, there is a high degree of inter- and intra-observer variability in image interpretation due to the different knowledge and experience of sonographers who have huge ultrasound examination tasks everyday. Artificial intelligence based on computer-aided diagnosis technology maybe improve the accuracy and time efficiency of thyroid nodules diagnosis. This study introduced an artificial intelligence software called SW-TH01/II to evaluate ultrasound image characteristics of thyroid nodules including echogenicity, shape, border, margin, and calcification. We included 225 ultrasound images from two hospitals in Shanghai, respectively. The sonographers and software performed characteristics analysis on the same group of images. We analyzed the consistency of the two results and used the sonographers' results as the gold standard to evaluate the accuracy of SW-TH01/II. A total of 449 images were included in the statistical analysis. For the seven indicators, the proportions of agreement between SW-TH01/II and sonographers' analysis results were all greater than 0.8. For the echogenicity (with very hypoechoic), aspect ratio and margin, the kappa coefficient between the two methods were above 0.75 (P < 0.001). The kappa coefficients of echogenicity (echotexture and echogenicity level), border and calcification between the two methods were above 0.6 (P < 0.001). The median time it takes for software and sonographers to interpret an image were 3 (2, 3) seconds and 26.5 (21.17, 34.33) seconds, respectively, and the difference were statistically significant (z = -18.36, P < 0.001). SW-TH01/II has a high degree of accuracy and great time efficiency benefits in judging the characteristics of thyroid nodule. It can provide more objective results and improve the efficiency of ultrasound examination. SW-TH01/II can be used to assist the sonographers in characterizing the thyroid nodule ultrasound images.
甲状腺结节作为一种常见的临床内分泌疾病,在全球范围内日益普遍。超声作为甲状腺成像的首要方法,在准确诊断和管理甲状腺结节方面发挥着重要作用。然而,由于超声检查人员每天承担着巨大的超声检查任务,其知识和经验各不相同,在图像解读方面存在高度的观察者间和观察者内变异性。基于计算机辅助诊断技术的人工智能可能会提高甲状腺结节诊断的准确性和时间效率。本研究引入了一款名为SW-TH01/II的人工智能软件,以评估甲状腺结节的超声图像特征,包括回声性、形状、边界、边缘和钙化情况。我们分别纳入了来自上海两家医院的225幅超声图像。超声检查人员和该软件对同一组图像进行了特征分析。我们分析了两种结果的一致性,并以超声检查人员的结果作为金标准来评估SW-TH01/II的准确性。共有449幅图像纳入统计分析。对于这七个指标,SW-TH01/II与超声检查人员分析结果之间的一致性比例均大于0.8。对于回声性(极低回声)、纵横比和边缘,两种方法之间的kappa系数均高于0.75(P < 0.001)。两种方法之间回声性(回声质地和回声水平)、边界和钙化的kappa系数均高于0.6(P < 0.001)。软件和超声检查人员解读一幅图像的中位时间分别为3(2,3)秒和26.5(21.17,34.33)秒,差异具有统计学意义(z = -18.36,P < 0.001)。SW-TH01/II在判断甲状腺结节特征方面具有高度准确性和显著的时间效率优势。它可以提供更客观的结果并提高超声检查的效率。SW-TH01/II可用于协助超声检查人员对甲状腺结节超声图像进行特征描述。