A Bayesian Network for Differentiating Benign From Malignant Thyroid Nodules Using Sonographic and Demographic Features

Liu, Yueyi I.; Kamaya, Aya; Desser, Terry S.; Rubin, Daniel L.

doi:10.2214/ajr.09.4037

Cited by 39 publications

(20 citation statements)

References 33 publications

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“…Similarly, numerous imaging classifiers exist to distinguish benign from malignant nodules (16, 34–37). The majority of these studies utilize ultrasound features and statistical models to select nodules with the highest cancer risk for FNA biopsy.…”

Section: Discussionmentioning

confidence: 99%

“…Nomograms combine clinical, laboratory, imaging, and demographic data (14, 15). There also has been interest in analyzing ultrasound features to predict malignancy, but no single feature is sensitive or specific enough to preclude surgery (16–18). More recently, several molecular tests have been developed to classify ITN as either benign or malignant.…”

Section: Introductionmentioning

confidence: 99%

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Gauging The Extent Of Thyroidectomy For Indeterminate Thyroid Nodules: An Oncologic Perspective

et al. 2017

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Introduction Increasing emphasis is being placed on appropriateness of care and avoidance of over- and under-treatment. Indeterminate thyroid nodules (ITN), present a particular risk for this problem because cancer found via diagnostic lobectomy (DL) often requires a completion thyroidectomy (CT). However, initial total thyroidectomy (TT) for benign ITN results in lifelong thyroid hormone replacement. We sought to measure the accuracy and factors associated with the extent of initial thyroidectomy for ITN. Methods We queried a single institution thyroid surgery database for all adult patients undergoing an initial operation for ITN. Multivariate logistic regression identified factors associated with either oncologic under- or over-treatment at initial operation. Results There were 639 patients with ITN. The median age was 52 (range 18 – 93), 78.4% were female, and final pathology revealed a cancer > 1 cm in 24.7%. The most common cytology was follicular neoplasm (45.1%) followed by Hurthle cell neoplasm (20.2%). CT or initial oncologic under-treatment was required in 58 patients (9.3%). Excluding those with goiters, 19.0% were treated with total thyroidectomy for benign final pathology. Multivariate analysis failed to identify any factor that independently predicted the need for CT. Female gender was associated with total thyroidectomy in benign disease (OR 2.1, 95% C.I. 1.0 – 4.5, p = 0.05). Age >45 predicted correct initial use of DL (OR 2.6, 95% C.I. 1.2 – 5.7, p = 0.02). Suspicious for PTC (OR 5.7, 95% C.I. 2.1 – 15.3, p<0.01) and frozen section (OR 9.7, 95% C.I. 2.5 – 38.6, p<0.01) were associated with oncologically appropriate initial TT. The highest frequency of CT occurred in patients with follicular lesion of undetermined significance (11.6%). Total thyroidectomy for benign final pathology occurred most frequently in patients with a Hurthle cell neoplasm (24.8%). Conclusions In patients with ITN, nearly 30% received an inappropriate extent of initial thyroidectomy from an oncologic standpoint. Tools to preoperatively identify both benign and malignant disease can assist in the complex decision-making to gauge the proper extent of initial surgery for ITN.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Gauging The Extent Of Thyroidectomy For Indeterminate Thyroid Nodules: An Oncologic Perspective

et al. 2017

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“…We only found 8 studies in this field, most of them using information from imaging tests or pathology reports. We considered laboratory information as a secondary step that should be applied after defining the risk of malignancy of the nodule (22)(23)(24)(25)(26)(27)(28)(29) If we consider individual variables, as shown in table 3, lower risk factors, as may be seen in middle-aged female patients, are assigned a malignancy probability of 19%, a patient without risk factors, such as radiotherapy or family history, is assigned a probability of 25% or a patient with multiple nodules that are smaller than 1 cm and have a soft consistency is assigned a probability of 20%, which are clearly higher than those reported in the literature, of finding carcinoma in an index nodule, which is approximately 5 to 15%. This was corroborated by the clinical cases, in which a patient without any risk factors is assigned a probability of malignancy of 19%, and in the final results that were obtained by the network, where a patient without risk factors has a basal probability of malignancy of 33%.…”

Section: Discussionmentioning

confidence: 99%

Los cirujanos sobreestiman el riesgo de malignidad de los nódulos tiroideos, evaluación de los estimados subjetivos usando un análisis bayesiano

2011

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Introduction: Thyroid nodules are the most common endocrine condition treated by surgeons. The main purpose of the evaluation of a thyroid nodule is to rule out a carcinoma. Medical decisions concerning thyroid nodules are highly influenced by subjective beliefs. Objective: To assess the subjective probabilities of malignancy that are assigned to the clinical characteristics of a patient with a thyroid nodule in order to determine the degree of influence that these probabilities have on the final clinical suspicion of malignancy compared with objective data. Material and methods: A bayesian analysis was designed to predict the risk of malignancy of a thyroid nodule based on the causal relationship between the demographic and clinical risk factors that are detected during the first consultation. A model with demographic and clinical variables using general surgeons as experts was developed. Results: The highest probability of malignancy (94%) was assigned to the pooled case of a male who was older than 60 years, with dysphonia, dysphagia, accelerated growth rate of the nodule and previous neck radiotherapy and who had a relative with thyroid cancer as well as multiple nodules that were larger than 1 cm and with hard consistency and palpable neck lymph nodes. For low risk cases in which the nodule characteristics are not suggestive of malignancy, the probability of malignancy assigned by clinicians was 33.59%; for high risk cases this was 75.54%. Conclusion: Surgeons make diagnostic decisions based on subjective beliefs that do not necessarily correspond to the objective measures of the characteristics of the nodules.

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“…For example, to built a Bayesian classifier to predict breast cancer. And also given that sonographic features predictive of malignancy have been extensively studied and the sensitivity and specificity of these features for malignancy are readily available [12]. In simple terms, a naive Bayes classifier assumes that the presence (or absence) of a particular feature of a class is unrelated to the presence (or absence) of any other feature, given the class variable.…”

Section: Bayesian Classifiermentioning

confidence: 99%

A Segmentation Method and Comparison of Classification Methods for Thyroid Ultrasound Images

Singh¹,

Jindal²

2012

IJCA

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In the conventional and relatively simple image processing techniques are most important task in the field of medical imaging. In this work to provide information about segmentation and classification methods that are very important for medical image processing. Ultrasound is unique in its ability to image patient anatomy and physiology in real time, providing an important, rapid and non-invasive means of evaluation. In this paper uses the groups of Benign and Malignant thyroid nodules images. These images used to analysis the classification accurately. GLCM extracts the total 13 features and these features are used to analysis in classifiers such as SVM, KNN and Bayesian. Experimental results illustrated that the classifiers like SVM/k-NN/Bayesian comparing to each other and enhanced classification accuracy. Result shows the SVM is best classification method and the performance measure such as accuracy. It is observed that the SVM gives much better accuracy than KNN and Bayesian.

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A Bayesian Network for Differentiating Benign From Malignant Thyroid Nodules Using Sonographic and Demographic Features

Abstract: We created a BN that incorporates a range of sonographic and demographic features and provides a probability about whether a thyroid nodule is benign or malignant. The BN distinguished between benign and malignant thyroid nodules as well as the expert radiologists did.

Cited by 39 publications

References 33 publications

Gauging The Extent Of Thyroidectomy For Indeterminate Thyroid Nodules: An Oncologic Perspective

Gauging The Extent Of Thyroidectomy For Indeterminate Thyroid Nodules: An Oncologic Perspective

Los cirujanos sobreestiman el riesgo de malignidad de los nódulos tiroideos, evaluación de los estimados subjetivos usando un análisis bayesiano

A Segmentation Method and Comparison of Classification Methods for Thyroid Ultrasound Images

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