False-Positive Malignant Diagnosis of Nodule Mimicking Lesions by Computer-Aided Thyroid Nodule Analysis in Clinical Ultrasonography Practice

Abstract

This study aims to test computer-aided diagnosis (CAD) for thyroid nodules in clinical ultrasonography (US) practice with a focus towards identifying thyroid entities associated with CAD system misdiagnoses. Two-hundred patients referred to thyroid US were prospectively enrolled. An experienced radiologist evaluated the thyroid nodules and saved axial images for further offline blinded analysis using a commercially available CAD system. To represent clinical practice, not only true nodules, but mimicking lesions were also included. Fine needle aspiration biopsy (FNAB) was performed according to present guidelines. US features and thyroid entities significantly associated with CAD system misdiagnosis were identified along with the diagnostic accuracy of the radiologist and the CAD system. Diagnostic specificity regarding the radiologist was significantly (p < 0.05) higher than when compared with the CAD system (88.1% vs. 40.5%) while no significant difference was found in the sensitivity (88.6% vs. 80%). Focal inhomogeneities and true nodules in thyroiditis, nodules with coarse calcification and inspissated colloid cystic nodules were significantly (p < 0.05) associated with CAD system misdiagnosis as false-positives. The commercially available CAD system is promising when used to exclude thyroid malignancies, however, it currently may not be able to reduce unnecessary FNABs, mainly due to the false-positive diagnoses of nodule mimicking lesions.

Diagnostic accuracy of S-Detect in distinguishing benign and malignant thyroid nodules: A meta-analysis

“…On this basis, we further reviewed the integrity of the content and data of the paper, and then excluded 6 papers. In the current meta-analysis, a total of 17 studies were used [7][8][9][10][13][14][15][16][17][18][19][20][21][22][23][24][25]. In Fig 1 of this paper, the selection method and main steps of the article are described in detail.…”

Ultrasonic S-Detect mode for the evaluation of thyroid nodules: A meta-analysis

“…Finally, 15 studies that met all inclusion criteria were included in this meta-analysis. [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] Figure 1 shows the selection process. A total of 924 thyroid malignant nodules and 1228 thyroid benign nodules were assessed.…”

“…We searched PubMed, Web of Science, Cochrane Library, and Chinese biomedical databases from inception through August 31, 2021. The following keywords and MeSH terms were used: [10] 2021 China Chinese 152 46.5 ± 12.8 Samsung RS80A 80 9 12 51 77 15 15 45 Yu [11] 2021 China Chinese 125 46.2 ± 11.5 Samsung RS80A 62 7 16 40 72 15 6 32 Qian [12] 2021 China Chinese 183 21-67 Samsung RS80A 103 19 12 49 94 24 21 44 Fang [13] 2021 China Chinese 94 44.9 ± 11.8 Samsung RS80A 55 7 2 30 52 3 5 34 Chen [14] 2020 China Chinese 136 47.5 ± 15.4 Samsung RS80A 49 40 7 40 46 16 10 64 Han [15] 2018 China Chinese 93 45.4 ± 12.5 Samsung RS80A 39 28 5 21 43 9 1 40 Szczepanek-Parulska [16] 2020 Poland English 133 49.5 ± 15.5 Samsung RS80A 59 13 7 54 61 26 5 41 Wei [17] 2020 China English 204 46 ± 12 Samsung RS80A 84 39 8 73 89 28 3 84 Barczyński [18] 2020 Poland English 50 47.5 ± 15.0 Samsung RS85A 9 8 1 32 8 10 2 30 Kim [19] 2019 Korea English 218 22-81 Samsung RS80A 69 23 17 109 73 5 13 127 Xia [20] 2019 China English 180 21-83 Samsung RS80A 86 50 9 35 77 17 18 68 Choi [21] 2018 Korea English 102 45 (25-76) Samsung RS80A 39 15 4 44 38 3 5 56 Yoo [22] 2018 Korea English 117 43 (22-81) Samsung RS80A 40 8 10 59 42 3 8 64 Chung [23] 2020 Korea English 165 51 (22-94) Samsung RS80A 23 17 2 123 21 3 4 137 Molnár [24] 2020 Hungary English ["thyroid cancer" or "thyroid neoplasm" or "thyroid tumor" or "thyroid nodule"] and ["S-Detect"]. We also performed a manual search to find other potentially suitable articles.…”