Aim The aim of this study is to evaluate the diagnostic value of machine learning- (ML-) based quantitative texture analysis in the differentiation of benign and malignant thyroid nodules. Materials and methods A sum of 306 quantitative textural features of 235 thyroid nodules (102 malignant, 43.4%; 133 benign, 56.4%) of a total of 198 patients were investigated using the random forest ML classifier. Feature selection and dimension reduction were conducted using reproducibility testing and a wrapper method. The diagnostic accuracy, sensitivity, specificity, and area under curve (AUC) of the proposed method were compared with the histopathological or cytopathological findings as reference methods. Results Of the 306 initial texture features, 284 (92.2%) showed good reproducibility (intraclass correlation ≥0.80). The random forest classifier accurately identified 87 out of 102 malignant thyroid nodules and 117 out of 133 benign thyroid nodules, which is a diagnostic sensitivity of 85.2%, specificity of 87.9%, and accuracy of 86.8%. The AUC of the model was 0.92. Conclusions Quantitative textural analysis of thyroid nodules using ML classification can accurately discriminate benign and malignant thyroid nodules. Our findings should be validated by multicenter prospective studies using completely independent external data.
To investigate the performance of a joint convolutional neural networks-recurrent neural networks (CNN-RNN) using an attention mechanism in identifying and classifying intracranial hemorrhage (ICH) on a large multi-center dataset; to test its performance in a prospective independent sample consisting of consecutive real-world patients. All consecutive patients who underwent emergency non-contrast-enhanced head CT in five different centers were retrospectively gathered. Five neuroradiologists created the ground-truth labels. The development dataset was divided into the training and validation set. After the development phase, we integrated the deep learning model into an independent center’s PACS environment for over six months for assessing the performance in a real clinical setting. Three radiologists created the ground-truth labels of the testing set with a majority voting. A total of 55,179 head CT scans of 48,070 patients, 28,253 men (58.77%), with a mean age of 53.84 ± 17.64 years (range 18–89) were enrolled in the study. The validation sample comprised 5211 head CT scans, with 991 being annotated as ICH-positive. The model's binary accuracy, sensitivity, and specificity on the validation set were 99.41%, 99.70%, and 98.91, respectively. During the prospective implementation, the model yielded an accuracy of 96.02% on 452 head CT scans with an average prediction time of 45 ± 8 s. The joint CNN-RNN model with an attention mechanism yielded excellent diagnostic accuracy in assessing ICH and its subtypes on a large-scale sample. The model was seamlessly integrated into the radiology workflow. Though slightly decreased performance, it provided decisions on the sample of consecutive real-world patients within a minute.
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