A s the most common cancer among women worldwide, breast cancer poses a great challenge to public health on a global scale (1). Identification of the presence of lymph node metastasis is pivotal for the pathologic staging, prognosis, and guidance of treatment in patients with breast cancer (2). Although several histopathologic findings, such as vascular and lymphatic invasion, epithelial hyperplasia, and necrosis, are associated with a higher risk for lymph node metastasis, they are available only postoperatively (3). The preoperative prediction of lymph node metastasis can provide valuable information for determining adjuvant therapy and developing surgical plans, thereby facilitating pretreatment decisions.Preoperative imaging assessment is of great value because of its convenient, comprehensive, and noninvasive properties. US plays a crucial role in detecting breast cancer and predicting lymph node metastasis (4). Most patients with early stage breast cancer who have clinically negative lymph nodes have no suspicious signs at either physical examination or imaging. Although radiologists often cannot find any signs of metastasis on US images of clinically negative lymph nodes, axillary lymph node metastasis is detected with sentinel lymph node biopsy in 15%-20% of patients (5). Several studies have found that numerous breast US characteristics are associated with lymph node metastasis. The distance
Artificial intelligence (AI), particularly deep learning algorithms, is gaining extensive attention for its excellent performance in image-recognition tasks. They can automatically make a quantitative assessment of complex medical image characteristics and achieve an increased accuracy for diagnosis with higher efficiency. AI is widely used and getting increasingly popular in the medical imaging of the liver, including radiology, ultrasound, and nuclear medicine. AI can assist physicians to make more accurate and reproductive imaging diagnosis and also reduce the physicians’ workload. This article illustrates basic technical knowledge about AI, including traditional machine learning and deep learning algorithms, especially convolutional neural networks, and their clinical application in the medical imaging of liver diseases, such as detecting and evaluating focal liver lesions, facilitating treatment, and predicting liver treatment response. We conclude that machine-assisted medical services will be a promising solution for future liver medical care. Lastly, we discuss the challenges and future directions of clinical application of deep learning techniques.
Artificial intelligence (AI) is gaining extensive attention for its excellent performance in image-recognition tasks and increasingly applied in breast ultrasound. AI can conduct a quantitative assessment by recognizing imaging information automatically and make more accurate and reproductive imaging diagnosis. Breast cancer is the most commonly diagnosed cancer in women, severely threatening women’s health, the early screening of which is closely related to the prognosis of patients. Therefore, utilization of AI in breast cancer screening and detection is of great significance, which can not only save time for radiologists, but also make up for experience and skill deficiency on some beginners. This article illustrates the basic technical knowledge regarding AI in breast ultrasound, including early machine learning algorithms and deep learning algorithms, and their application in the differential diagnosis of benign and malignant masses. At last, we talk about the future perspectives of AI in breast ultrasound.
ObjectiveThe purpose of this study was to improve the differentiation between malignant and benign thyroid nodules using deep learning (DL) in category 4 and 5 based on the Thyroid Imaging Reporting and Data System (TI-RADS, TR) from the American College of Radiology (ACR).Design and MethodsFrom June 2, 2017 to April 23, 2019, 2082 thyroid ultrasound images from 1396 consecutive patients with confirmed pathology were retrospectively collected, of which 1289 nodules were category 4 (TR4) and 793 nodules were category 5 (TR5). Ninety percent of the B-mode ultrasound images were applied for training and validation, and the residual 10% and an independent external dataset for testing purpose by three different deep learning algorithms.ResultsIn the independent test set, the DL algorithm of best performance got an AUC of 0.904, 0.845, 0.829 in TR4, TR5, and TR4&5, respectively. The sensitivity and specificity of the optimal model was 0.829, 0.831 on TR4, 0.846, 0.778 on TR5, 0.790, 0.779 on TR4&5, versus the radiologists of 0.686 (P=0.108), 0.766 (P=0.101), 0.677 (P=0.211), 0.750 (P=0.128), and 0.680 (P=0.023), 0.761 (P=0.530), respectively.ConclusionsThe study demonstrated that DL could improve the differentiation of malignant from benign thyroid nodules and had significant potential for clinical application on TR4 and TR5.
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