1
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Liu Z, Zhang X, Zhao X, Guo Q, Li Z, Wei M, Niu L, An C. Combining radiomics with thyroid imaging reporting and data system to predict lateral cervical lymph node metastases in medullary thyroid cancer. BMC Med Imaging 2024; 24:64. [PMID: 38500053 PMCID: PMC10946103 DOI: 10.1186/s12880-024-01222-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/05/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Medullary Thyroid Carcinoma (MTC) is a rare type of thyroid cancer. Accurate prediction of lateral cervical lymph node metastases (LCLNM) in MTC patients can help guide surgical decisions and ensure that patients receive the most appropriate and effective surgery. To our knowledge, no studies have been published that use radiomics analysis to forecast LCLNM in MTC patients. The purpose of this study is to develop a radiomics combined with thyroid imaging reporting and data system (TI-RADS) model that can use preoperative thyroid ultrasound images to noninvasively predict the LCLNM status of MTC. METHODS We retrospectively included 218 MTC patients who were confirmed from postoperative pathology as LCLNM negative (n=111) and positive (n=107). Ultrasound features were selected using the Student's t-test, while radiomics features are first extracted from preoperative thyroid ultrasound images, and then a two-step feature selection approach was used to select features. These features are then used to establish three regularized logistic regression models, namely the TI-RADS model (TM), the radiomics model (RM), and the radiomics-TI-RADS model (RTM), in 5-fold cross-validation to determine the likelihood of the LCLNM. The Delong's test and decision curve analysis (DCA) were used to evaluate and compare the performance of the models. RESULTS The ultrasound features of margin and TI-RADS level, and a total of 12 selected radiomics features, were significantly different between the LCLNM negative and positive groups (p<0.05). The TM, RM, and RTM yielded an averaged AUC of 0.68±0.05, 0.78±0.06, and 0.82±0.05 in the 5-fold cross-validation dataset, respectively. RM and RTM are statistically better than TM (p<0.05 and p<0.001) according to Delong test. DCA demonstrates that RTM brings more benefit than TM and RM. CONCLUSIONS We have developed a joint radiomics-based model for noninvasive prediction of the LCLNM in MTC patients solely using preoperative thyroid ultrasound imaging. It has the potential to be used as a complementary tool to help guide treatment decisions for this rare form of thyroid cancer.
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Affiliation(s)
- Zhiqiang Liu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China
| | - Xiwei Zhang
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17, Panjiayuan Nanli, Chaoyang District, Beijing, 100021, P.R. China
| | - Xiaohui Zhao
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17, Panjiayuan Nanli, Chaoyang District, Beijing, 100021, P.R. China
| | - Qianqian Guo
- Department of Ultrasound, Qilu Hospital of Shandong University, Jinan, Shandong, P.R. China
| | - Zhengjiang Li
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17, Panjiayuan Nanli, Chaoyang District, Beijing, 100021, P.R. China
| | - Minghui Wei
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China
| | - Lijuan Niu
- Department of Ultrasound, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17, Panjiayuan Nanli, Chaoyang District, Beijing, 100021, P.R. China.
| | - Changming An
- Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17, Panjiayuan Nanli, Chaoyang District, Beijing, 100021, P.R. China.
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Zhang H, Yang YF, Yang C, Yang YY, He XH, Chen C, Song XL, Ying LL, Wang Y, Xu LC, Li WT. A Novel Interpretable Radiomics Model to Distinguish Nodular Goiter From Malignant Thyroid Nodules. J Comput Assist Tomogr 2024; 48:334-342. [PMID: 37757802 DOI: 10.1097/rct.0000000000001544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
OBJECTIVES The purpose of this study is to inquire about the potential association between radiomics features and the pathological nature of thyroid nodules (TNs), and to propose an interpretable radiomics-based model for predicting the risk of malignant TN. METHODS In this retrospective study, computed tomography (CT) imaging and pathological data from 141 patients with TN were collected. The data were randomly stratified into a training group (n = 112) and a validation group (n = 29) at a ratio of 4:1. A total of 1316 radiomics features were extracted by using the pyradiomics tool. The redundant features were removed through correlation testing, and the least absolute shrinkage and selection operator (LASSO) or the minimum redundancy maximum relevance standard was used to select features. Finally, 4 different machine learning models (RF Hybrid Feature, SVM Hybrid Feature, RF, and LASSO) were constructed. The performance of the 4 models was evaluated using the receiver operating characteristic curve. The calibration curve, decision curve analysis, and SHapley Additive exPlanations method were used to evaluate or explain the best radiomics machine learning model. RESULTS The optimal radiomics model (RF Hybrid Feature model) demonstrated a relatively high degree of discrimination with an area under the receiver operating characteristic curve (AUC) of 0.87 (95% CI, 0.70-0.97; P < 0.001) for the validation cohort. Compared with the commonly used LASSO model (AUC, 0.78; 95% CI, 0.60-0.91; P < 0.01), there is a significant improvement in AUC in the validation set, net reclassification improvement, 0.79 (95% CI, 0.13-1.46; P < 0.05), and integrated discrimination improvement, 0. 20 (95% CI, 0.10-0.30; P < 0.001). CONCLUSION The interpretable radiomics model based on CT performs well in predicting benign and malignant TNs by using quantitative radiomics features of the unilateral total thyroid. In addition, the data preprocessing method incorporating different layers of features has achieved excellent experimental results. CLINICAL RELEVANCE STATEMENT As the detection rate of TNs continues to increase, so does the diagnostic burden on radiologists. This study establishes a noninvasive, interpretable and accurate machine learning model to rapidly identify the nature of TN found in CT.
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Affiliation(s)
- Hao Zhang
- From the Department of Interventional Radiology, Fudan University Shanghai Cancer Center
| | | | - Chao Yang
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University
| | | | | | | | - Xue-Lin Song
- Department of Radiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
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Ren JY, Lv WZ, Wang L, Zhang W, Ma YY, Huang YZ, Peng YX, Lin JJ, Cui XW. Dual-modal radiomics nomogram based on contrast-enhanced ultrasound to improve differential diagnostic accuracy and reduce unnecessary biopsy rate in ACR TI-RADS 4-5 thyroid nodules. Cancer Imaging 2024; 24:17. [PMID: 38263209 PMCID: PMC10807093 DOI: 10.1186/s40644-024-00661-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 01/10/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS, TR) 4 and 5 thyroid nodules (TNs) demonstrate much more complicated and overlapping risk characteristics than TR1-3 and have a rather wide range of malignancy possibilities (> 5%), which may cause overdiagnosis or misdiagnosis. This study was designed to establish and validate a dual-modal ultrasound (US) radiomics nomogram integrating B-mode ultrasound (BMUS) and contrast-enhanced ultrasound (CEUS) imaging to improve differential diagnostic accuracy and reduce unnecessary fine needle aspiration biopsy (FNAB) rates in TR 4-5 TNs. METHODS A retrospective dataset of 312 pathologically confirmed TR4-5 TNs from 269 patients was collected for our study. Data were randomly divided into a training dataset of 219 TNs and a validation dataset of 93 TNs. Radiomics characteristics were derived from the BMUS and CEUS images. After feature reduction, the BMUS and CEUS radiomics scores (Rad-score) were built. A multivariate logistic regression analysis was conducted incorporating both Rad-scores and clinical/US data, and a radiomics nomogram was subsequently developed. The performance of the radiomics nomogram was evaluated using calibration, discrimination, and clinical usefulness, and the unnecessary FNAB rate was also calculated. RESULTS BMUS Rad-score, CEUS Rad-score, age, shape, margin, and enhancement direction were significant independent predictors associated with malignant TR4-5 TNs. The radiomics nomogram involving the six variables exhibited excellent calibration and discrimination in the training and validation cohorts, with an AUC of 0.873 (95% CI, 0.821-0.925) and 0.851 (95% CI, 0.764-0.938), respectively. The marked improvements in the net reclassification index and integrated discriminatory improvement suggested that the BMUS and CEUS Rad-scores could be valuable indicators for distinguishing benign from malignant TR4-5 TNs. Decision curve analysis demonstrated that our developed radiomics nomogram was an instrumental tool for clinical decision-making. Using the radiomics nomogram, the unnecessary FNAB rate decreased from 35.3 to 14.5% in the training cohort and from 41.5 to 17.7% in the validation cohorts compared with ACR TI-RADS. CONCLUSION The dual-modal US radiomics nomogram revealed superior discrimination accuracy and considerably decreased unnecessary FNAB rates in benign and malignant TR4-5 TNs. It could guide further examination or treatment options.
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Affiliation(s)
- Jia-Yu Ren
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wen-Zhi Lv
- Department of Artificial Intelligence, Julei Technology Company, Wuhan, China
| | - Liang Wang
- Center of Computer, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Zhang
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ying-Ying Ma
- Department of Medical Ultrasound, The First People's Hospital of Qinzhou, Qinzhou, China
| | - Yong-Zhen Huang
- Department of Medical Ultrasound, The First People's Hospital of Qinzhou, Qinzhou, China
| | - Yue-Xiang Peng
- Department of Medical Ultrasound, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan, China
| | - Jian-Jun Lin
- Department of Medical Ultrasound, The First People's Hospital of Qinzhou, Qinzhou, China.
| | - Xin-Wu Cui
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Xu YD, Tang Y, Zhang Q, Zhao ZY, Zhao CK, Fan PL, Jin YJ, Ji ZB, Han H, Xu HX, Shi YL, Xu BH, Li XL. Automatic detection of thyroid nodules with a real-time artificial intelligence system in a real clinical scenario and the associated influencing factors. Clin Hemorheol Microcirc 2024; 87:437-450. [PMID: 38489169 DOI: 10.3233/ch-242099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
BACKGROUND At present, most articles mainly focused on the diagnosis of thyroid nodules by using artificial intelligence (AI), and there was little research on the detection performance of AI in thyroid nodules. OBJECTIVE To explore the value of a real-time AI based on computer-aided diagnosis system in the detection of thyroid nodules and to analyze the factors influencing the detection accuracy. METHODS From June 1, 2022 to December 31, 2023, 224 consecutive patients with 587 thyroid nodules were prospective collected. Based on the detection results determined by two experienced radiologists (both with more than 15 years experience in thyroid diagnosis), the detection ability of thyroid nodules of radiologists with different experience levels (junior radiologist with 1 year experience and senior radiologist with 5 years experience in thyroid diagnosis) and real-time AI were compared. According to the logistic regression analysis, the factors influencing the real-time AI detection of thyroid nodules were analyzed. RESULTS The detection rate of thyroid nodules by real-time AI was significantly higher than that of junior radiologist (P = 0.013), but lower than that of senior radiologist (P = 0.001). Multivariate logistic regression analysis showed that nodules size, superior pole, outside (near carotid artery), close to vessel, echogenicity (isoechoic, hyperechoic, mixed-echoic), morphology (not very regular, irregular), margin (unclear), ACR TI-RADS category 4 and 5 were significant independent influencing factors (all P < 0.05). With the combination of real-time AI and radiologists, junior and senior radiologist increased the detection rate to 97.4% (P < 0.001) and 99.1% (P = 0.015) respectively. CONCLUSONS The real-time AI has good performance in thyroid nodule detection and can be a good auxiliary tool in the clinical work of radiologists.
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Affiliation(s)
- Ya-Dan Xu
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
- Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, China
- Shanghai Institute of Medical Imaging, Shanghai, China
| | - Yang Tang
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
- Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, China
| | - Qi Zhang
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
- Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, China
| | - Zheng-Yong Zhao
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Chong-Ke Zhao
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Pei-Li Fan
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
- Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, China
| | - Yun-Jie Jin
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
- Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, China
| | - Zheng-Biao Ji
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
- Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, China
| | - Hong Han
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
- Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, China
- Shanghai Institute of Medical Imaging, Shanghai, China
| | - Hui-Xiong Xu
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
- Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, China
- Shanghai Institute of Medical Imaging, Shanghai, China
| | | | - Ben-Hua Xu
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
- Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, China
| | - Xiao-Long Li
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
- Institute of Ultrasound in Medicine and Engineering, Fudan University, Shanghai, China
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5
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Moon J, Lee JH, Roh J, Lee DH, Ha EJ. Contrast-enhanced CT-based Radiomics for the Differentiation of Anaplastic or Poorly Differentiated Thyroid Carcinoma from Differentiated Thyroid Carcinoma: A Pilot Study. Sci Rep 2023; 13:4562. [PMID: 36941287 PMCID: PMC10027684 DOI: 10.1038/s41598-023-31212-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 03/08/2023] [Indexed: 03/23/2023] Open
Abstract
Differential diagnosis of anaplastic thyroid carcinoma/poorly differentiated thyroid carcinoma (ATC/PDTC) from differentiated thyroid carcinoma (DTC) is crucial in patients with large thyroid malignancies. This study creates a predictive model using radiomics feature analysis to differentiate ATC/PDTC from DTC. We compared the clinicoradiological characteristics and radiomics features extracted from a volume of interest on contrast-enhanced computed tomography (CT) between the groups. Estimations of variable importance were performed via modeling using the random forest quantile classifier. The diagnostic performance of the model with radiomics features alone had the area under the receiver operating characteristic (AUROC) curve value of 0.883. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were 81.7%, 93.3%, 97.7%, 64.5%, and 84.6%, respectively, for the differential diagnosis of ATC/PDTC and DTC. The model with both radiomics and clinicoradiological information showed the AUROC of 0.908, with sensitivity, specificity, PPV, NPV, and accuracy of 82.9%, 97.6%, 99.2%, 67.1%, and 86.5% respectively. Distant metastasis, moment, shape, age, and gray-level size zone matrix features were the most useful factors for differential diagnosis. Therefore, we concluded that a radiomics approach based on contrast-enhanced CT features can potentially differentiate ATC/PDTC from DTC in patients with large thyroid malignancies.
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Affiliation(s)
- Jayoung Moon
- Department of Radiology, Ajou University School of Medicine, Wonchon-dong, Yeongtong-gu, Suwon, 16499, Korea
| | - Jeong Hoon Lee
- Department of Radiology, Ajou University School of Medicine, Wonchon-dong, Yeongtong-gu, Suwon, 16499, Korea
| | - Jin Roh
- Department of Pathology, Ajou University School of Medicine, Wonchon-dong, Yeongtong-gu, Suwon, 16499, Korea
| | - Da Hyun Lee
- Department of Radiology, Ajou University School of Medicine, Wonchon-dong, Yeongtong-gu, Suwon, 16499, Korea
| | - Eun Ju Ha
- Department of Radiology, Ajou University School of Medicine, Wonchon-dong, Yeongtong-gu, Suwon, 16499, Korea.
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Gao X, Ran X, Ding W. The progress of radiomics in thyroid nodules. Front Oncol 2023; 13:1109319. [PMID: 36959790 PMCID: PMC10029726 DOI: 10.3389/fonc.2023.1109319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 02/03/2023] [Indexed: 03/09/2023] Open
Abstract
Due to the development of Artificial Intelligence (AI), Machine Learning (ML), and the improvement of medical imaging equipment, radiomics has become a popular research in recent years. Radiomics can obtain various quantitative features from medical images, highlighting the invisible image traits and significantly enhancing the ability of medical imaging identification and prediction. The literature indicates that radiomics has a high potential in identifying and predicting thyroid nodules. So in this article, we explain the development, definition, and workflow of radiomics. And then, we summarize the applications of various imaging techniques in identifying benign and malignant thyroid nodules, predicting invasiveness and metastasis of thyroid lymph nodes, forecasting the prognosis of thyroid malignancies, and some new advances in molecular level and deep learning. The shortcomings of this technique are also summarized, and future development prospects are provided.
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Affiliation(s)
| | - Xuan Ran
- *Correspondence: Wei Ding, ; Xuan Ran,
| | - Wei Ding
- *Correspondence: Wei Ding, ; Xuan Ran,
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Wang P, Zhang L, Ren J, Jiang R, Wu F, Du FZ, Sheng JP, Li JH. The accuracy of CT imaging in differential diagnosis of accidental thyroid nodules based on histopathology findings. JOURNAL OF RADIATION RESEARCH AND APPLIED SCIENCES 2022. [DOI: 10.1016/j.jrras.2022.100477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Sorrenti S, Dolcetti V, Radzina M, Bellini MI, Frezza F, Munir K, Grani G, Durante C, D’Andrea V, David E, Calò PG, Lori E, Cantisani V. Artificial Intelligence for Thyroid Nodule Characterization: Where Are We Standing? Cancers (Basel) 2022; 14:cancers14143357. [PMID: 35884418 PMCID: PMC9315681 DOI: 10.3390/cancers14143357] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/24/2022] [Accepted: 07/08/2022] [Indexed: 12/12/2022] Open
Abstract
Simple Summary In the present review, an up-to-date summary of the state of the art of artificial intelligence (AI) implementation for thyroid nodule characterization and cancer is provided. The opinion on the real effectiveness of AI systems remains controversial. Taking into consideration the largest and most scientifically valid studies, it is possible to state that AI provides results that are comparable or inferior to expert ultrasound specialists and radiologists. Promising data approve AI as a support tool and simultaneously highlight the need for a radiologist supervisory framework for AI provided results. Therefore, current solutions might be more suitable for educational purposes. Abstract Machine learning (ML) is an interdisciplinary sector in the subset of artificial intelligence (AI) that creates systems to set up logical connections using algorithms, and thus offers predictions for complex data analysis. In the present review, an up-to-date summary of the current state of the art regarding ML and AI implementation for thyroid nodule ultrasound characterization and cancer is provided, highlighting controversies over AI application as well as possible benefits of ML, such as, for example, training purposes. There is evidence that AI increases diagnostic accuracy and significantly limits inter-observer variability by using standardized mathematical algorithms. It could also be of aid in practice settings with limited sub-specialty expertise, offering a second opinion by means of radiomics and computer-assisted diagnosis. The introduction of AI represents a revolutionary event in thyroid nodule evaluation, but key issues for further implementation include integration with radiologist expertise, impact on workflow and efficiency, and performance monitoring.
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Affiliation(s)
- Salvatore Sorrenti
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (S.S.); (V.D.); (E.L.)
| | - Vincenzo Dolcetti
- Department of Radiological, Anatomo-Pathological Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (V.D.); (V.C.)
| | - Maija Radzina
- Radiology Research Laboratory, Riga Stradins University, LV-1007 Riga, Latvia;
- Medical Faculty, University of Latvia, Diagnostic Radiology Institute, Paula Stradina Clinical University Hospital, LV-1007 Riga, Latvia
| | - Maria Irene Bellini
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (S.S.); (V.D.); (E.L.)
- Correspondence:
| | - Fabrizio Frezza
- Department of Information Engineering, Electronics and Telecommunications, “Sapienza” University of Rome, 00184 Rome, Italy; (F.F.); (K.M.)
- Consorzio Nazionale Interuniversitario per le Telecomunicazioni (CNIT), Viale G.P. Usberti 181/A Sede Scientifica di Ingegneria-Palazzina 3, 43124 Parma, Italy
| | - Khushboo Munir
- Department of Information Engineering, Electronics and Telecommunications, “Sapienza” University of Rome, 00184 Rome, Italy; (F.F.); (K.M.)
| | - Giorgio Grani
- Department of Translational and Precision Medicine, “Sapienza” University of Rome, 00161 Rome, Italy; (G.G.); (C.D.); (E.D.)
| | - Cosimo Durante
- Department of Translational and Precision Medicine, “Sapienza” University of Rome, 00161 Rome, Italy; (G.G.); (C.D.); (E.D.)
| | - Vito D’Andrea
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (S.S.); (V.D.); (E.L.)
| | - Emanuele David
- Department of Translational and Precision Medicine, “Sapienza” University of Rome, 00161 Rome, Italy; (G.G.); (C.D.); (E.D.)
| | - Pietro Giorgio Calò
- Department of Surgical Sciences, “Policlinico Universitario Duilio Casula”, University of Cagliari, 09042 Monserrato, Italy;
| | - Eleonora Lori
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (S.S.); (V.D.); (E.L.)
| | - Vito Cantisani
- Department of Radiological, Anatomo-Pathological Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (V.D.); (V.C.)
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Zhao L, Ma B. Radiomics Features of Different Sizes of Medullary Thyroid Carcinoma (MTC) and Papillary Thyroid Carcinoma (PTC) Tumors: A Comparative Study. Clin Med Insights Oncol 2022; 16:11795549221097675. [PMID: 35603093 PMCID: PMC9121460 DOI: 10.1177/11795549221097675] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 04/08/2022] [Indexed: 02/05/2023] Open
Abstract
Background: Radiomics strategies exhibit great promise in the context of thyroid nodule
diagnosis. This study aimed to compare radiomics features of different sizes
of medullary thyroid carcinoma (MTC) and papillary thyroid carcinoma (PTC)
tumors and to compare the efficiency of radiomics approaches as a means of
differentiating between these tumor types. Methods: In total, 86 MTC and 330 PTC nodules were divided into the macronodular
(>10 mm) and micronodular (⩽10 mm) categories. The radiomics features of
these nodules were analyzed to identify independent prognosis factors and
evaluate the efficacy of individual and combined indicators as predictors of
tumor type. Results: In total, 12 radiomics features were found to differ significantly between
MTC and PTC macronodules, while 6 differed significantly between MTC and PTC
micronodules. Shape 2D_Sphericity, firstorder_Skewness,
glrlm_RunLengthNonUniformity, glszm_GrayLevelNonUniformity, and
glszm_SizeZoneNonUniformity were features that were independently associated
with the differential diagnoses of MTC and PTC macronodules. Receiver
operating characteristic (ROC) curve analyses of the efficacy of these 5
single indicators and a combined indicator composed thereof yielded area
under the curve (AUC) values of 0.621, 0.678, 0.704, 0.762, 0.747, and
0.824, respectively, with respective sensitivities of 55.3%, 43.0%, 53.1%,
56.3%, 46.9%, and 65.6%, and respective specificity values of 65.6%, 89.1%,
81.6%, 88.8%, 95.0%, and 91.1%. The glrlm_RunEntropy and
glszm_SizeZoneNonUniformity features were identified as independent factors
associated with the differential diagnoses of MTC and PTC micronodules.
Receiver operating characteristic curve analyses of the efficacy of these 2
single indicators and a combined indicator composed thereof yielded
respective AUC values of 0.678, 0.678, and 0.771; Sensitivities of 57.0%,
72.7%, and 72.7%; and specificities of 77.3%, 64.2%, and 77.5%. Conclusions: A range of different radiomics features can enable effective differentiation
between MTC and PTC nodules of different sizes. Moreover, analyses of
combinations of radiomics features yielded diagnostic efficiency values
higher than those associated with single radiomics features, highlighting a
more reliable approach to diagnosing MTC and PTC tumors.
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Affiliation(s)
- Ling Zhao
- Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, China.,Department of Ultrasound, Chinese People's Liberation Army 63820 Hospital, Mianyang, China
| | - Buyun Ma
- Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, China
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10
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Cleere EF, Davey MG, O’Neill S, Corbett M, O’Donnell JP, Hacking S, Keogh IJ, Lowery AJ, Kerin MJ. Radiomic Detection of Malignancy within Thyroid Nodules Using Ultrasonography-A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2022; 12:diagnostics12040794. [PMID: 35453841 PMCID: PMC9027085 DOI: 10.3390/diagnostics12040794] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 03/22/2022] [Accepted: 03/22/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Despite investigation, 95% of thyroid nodules are ultimately benign. Radiomics is a field that uses radiological features to inform individualized patient care. We aimed to evaluate the diagnostic utility of radiomics in classifying undetermined thyroid nodules into benign and malignant using ultrasonography (US). Methods: A diagnostic test accuracy systematic review and meta-analysis was performed in accordance with PRISMA guidelines. Sensitivity, specificity, and area under curve (AUC) delineating benign and malignant lesions were recorded. Results: Seventy-five studies including 26,373 patients and 46,175 thyroid nodules met inclusion criteria. Males accounted for 24.6% of patients, while 75.4% of patients were female. Radiomics provided a pooled sensitivity of 0.87 (95% CI: 0.86−0.87) and a pooled specificity of 0.84 (95% CI: 0.84−0.85) for characterizing benign and malignant lesions. Using convolutional neural network (CNN) methods, pooled sensitivity was 0.85 (95% CI: 0.84−0.86) and pooled specificity was 0.82 (95% CI: 0.82−0.83); significantly lower than studies using non-CNN: sensitivity 0.90 (95% CI: 0.89−0.90) and specificity 0.88 (95% CI: 0.87−0.89) (p < 0.05). The diagnostic ability of radiologists and radiomics were comparable for both sensitivity (OR 0.98) and specificity (OR 0.95). Conclusions: Radiomic analysis using US provides a reproducible, reliable evaluation of undetermined thyroid nodules when compared to current best practice.
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Affiliation(s)
- Eoin F. Cleere
- The Lambe Institute for Translational Research, National University of Ireland, H91 YR71 Galway, Ireland; (M.G.D.); (A.J.L.); (M.J.K.)
- Department of Otolaryngology, Galway University Hospitals, H91 YR71 Galway, Ireland; (M.C.); (I.J.K.)
- Correspondence:
| | - Matthew G. Davey
- The Lambe Institute for Translational Research, National University of Ireland, H91 YR71 Galway, Ireland; (M.G.D.); (A.J.L.); (M.J.K.)
| | - Shane O’Neill
- Department of Breast and Endocrine Surgery, Galway University Hospitals, H91 YR71 Galway, Ireland;
| | - Mel Corbett
- Department of Otolaryngology, Galway University Hospitals, H91 YR71 Galway, Ireland; (M.C.); (I.J.K.)
| | - John P O’Donnell
- Department of Radiology, Galway University Hospitals, H91 YR71 Galway, Ireland;
| | - Sean Hacking
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA;
| | - Ivan J. Keogh
- Department of Otolaryngology, Galway University Hospitals, H91 YR71 Galway, Ireland; (M.C.); (I.J.K.)
| | - Aoife J. Lowery
- The Lambe Institute for Translational Research, National University of Ireland, H91 YR71 Galway, Ireland; (M.G.D.); (A.J.L.); (M.J.K.)
- Department of Breast and Endocrine Surgery, Galway University Hospitals, H91 YR71 Galway, Ireland;
| | - Michael J. Kerin
- The Lambe Institute for Translational Research, National University of Ireland, H91 YR71 Galway, Ireland; (M.G.D.); (A.J.L.); (M.J.K.)
- Department of Breast and Endocrine Surgery, Galway University Hospitals, H91 YR71 Galway, Ireland;
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11
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Application of Machine Learning Methods to Improve the Performance of Ultrasound in Head and Neck Oncology: A Literature Review. Cancers (Basel) 2022; 14:cancers14030665. [PMID: 35158932 PMCID: PMC8833587 DOI: 10.3390/cancers14030665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/19/2022] [Accepted: 01/26/2022] [Indexed: 01/06/2023] Open
Abstract
Simple Summary Ultrasound (US) is a non-invasive imaging method that is routinely utilized in head and neck cancer patients to assess the anatomic extent of tumors, nodal and non-nodal neck masses and for imaging the salivary glands. In this review, we summarize the present evidence on whether the application of machine learning (ML) methods can potentially improve the performance of US in head and neck cancer patients. We found that published clinical literature on ML methods applied to US datasets was limited but showed evidence of improved diagnostic and prognostic performance. However, a majority of these studies were based on retrospective evaluation and conducted at a single center with a limited number of datasets. The conduct of multi-center studies could help better validate the performance of ML-based US radiomics and facilitate the integration of these approaches into routine clinical practice. Abstract Radiomics is a rapidly growing area of research within radiology that involves the extraction and modeling of high-dimensional quantitative imaging features using machine learning/artificial intelligence (ML/AI) methods. In this review, we describe the published clinical evidence on the application of ML methods to improve the performance of ultrasound (US) in head and neck oncology. A systematic search of electronic databases (MEDLINE, PubMed, clinicaltrials.gov) was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Of 15,080 initial articles identified, 34 studies were selected for in-depth analysis. Twenty-five out of 34 studies (74%) focused on the diagnostic application of US radiomics while 6 (18%) studies focused on response assessment and 3 (8%) studies utilized US radiomics for modeling normal tissue toxicity. Support vector machine (SVM) was the most commonly employed ML method (47%) followed by multivariate logistic regression (24%) and k-nearest neighbor analysis (21%). Only 11/34 (~32%) of the studies included an independent validation set. A majority of studies were retrospective in nature (76%) and based on single-center evaluation (85%) with variable numbers of patients (12–1609) and imaging datasets (32–1624). Despite these limitations, the application of ML methods resulted in improved diagnostic and prognostic performance of US highlighting the potential clinical utility of this approach.
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12
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De Santi B, Spaggiari G, Granata AR, Romeo M, Molinari F, Simoni M, Santi D. From subjective to objective: A pilot study on testicular radiomics analysis as a measure of gonadal function. Andrology 2021; 10:505-517. [PMID: 34817934 PMCID: PMC9299912 DOI: 10.1111/andr.13131] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/16/2021] [Accepted: 11/19/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND The connection between testicular ultrasound (US) parameters and testicular function, including both spermato- and steroidogenesis has been largely suggested, but their predictive properties are not routinely applied. Radiomics, a new engineering approach to radiological imaging, could overcome the visual limit of the sonographer. OBJECTIVES This study is aimed at extracting objective testicular US features, correlating with testicular function, including both spermato- and steroidogenesis, using an engineering approach, in order to overcome the operator-dependent subjectivity. MATERIALS AND METHODS Prospective observational pilot study from December 2019 to December 2020 on normozoospermic subjects and patients with semen variables alterations, excluding azoospermia. All patients underwent conventional semen analysis, pituitary-gonadal hormones assessment, and testicular US, performed by the same operator. US images were analyzed by Biolab (Turin) throughout image segmentation, image pre-processing, and texture features extraction. RESULTS One hundred seventy US testicular images were collected from 85 patients (age 38.6 ± 9.1 years). A total of 44 first-order and advanced features were extracted. US inhomogeneity defined by radiomics significantly correlates with the andrologist definition, showing for the first time a mathematical quantification of a subjective US evaluation. Thirteen US texture features correlated with semen parameters, predicting sperm concentration, total sperm number, progressive motility, total motility and morphology, and with gonadotropins serum levels, but not with total testosterone serum levels. Classification analyses confirmed that US textural features predicted patients' classification according to semen parameters alterations. CONCLUSIONS Radiomics texture features qualitatively describe the testicular parenchyma with objective and reliable quantitative parameters, reflecting both the testicular spermatogenic capability and the action of pituitary gonadotropins. This is an innovative model in which US texture features represent a mirror of the pituitary-gonadal homeostasis in terms of reproductive function.
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Affiliation(s)
- Bruno De Santi
- Biolab, Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
| | - Giorgia Spaggiari
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy
| | - Antonio Rm Granata
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy
| | - Marilina Romeo
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy.,Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Filippo Molinari
- Biolab, Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
| | - Manuela Simoni
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy.,Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Daniele Santi
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy.,Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
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13
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Cao Y, Zhong X, Diao W, Mu J, Cheng Y, Jia Z. Radiomics in Differentiated Thyroid Cancer and Nodules: Explorations, Application, and Limitations. Cancers (Basel) 2021; 13:2436. [PMID: 34069887 PMCID: PMC8157383 DOI: 10.3390/cancers13102436] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/13/2021] [Accepted: 05/16/2021] [Indexed: 02/05/2023] Open
Abstract
Radiomics is an emerging technique that allows the quantitative extraction of high-throughput features from single or multiple medical images, which cannot be observed directly with the naked eye, and then applies to machine learning approaches to construct classification or prediction models. This method makes it possible to evaluate tumor status and to differentiate malignant from benign tumors or nodules in a more objective manner. To date, the classification and prediction value of radiomics in DTC patients have been inconsistent. Herein, we summarize the available literature on the classification and prediction performance of radiomics-based DTC in various imaging techniques. More specifically, we reviewed the recent literature to discuss the capacity of radiomics to predict lymph node (LN) metastasis, distant metastasis, tumor extrathyroidal extension, disease-free survival, and B-Raf proto-oncogene serine/threonine kinase (BRAF) mutation and differentiate malignant from benign nodules. This review discusses the application and limitations of the radiomics process, and explores its ability to improve clinical decision-making with the hope of emphasizing its utility for DTC patients.
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Affiliation(s)
- Yuan Cao
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu 610040, China; (Y.C.); (X.Z.); (W.D.); (J.M.)
| | - Xiao Zhong
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu 610040, China; (Y.C.); (X.Z.); (W.D.); (J.M.)
| | - Wei Diao
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu 610040, China; (Y.C.); (X.Z.); (W.D.); (J.M.)
| | - Jingshi Mu
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu 610040, China; (Y.C.); (X.Z.); (W.D.); (J.M.)
| | - Yue Cheng
- Department of Radiology, West China Hospital of Sichuan University, Chengdu 610040, China;
| | - Zhiyun Jia
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu 610040, China; (Y.C.); (X.Z.); (W.D.); (J.M.)
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