A thyroid nodule, a common abnormal growth within the thyroid gland, is often identified through ultrasound imaging of the neck. These growths may be solid- or fluid-filled, and their treatment is influenced by factors such as size and location. The Thyroid Imaging Reporting and Data System (TI-RADS) is a classification method that categorizes thyroid nodules into risk levels based on features such as size, echogenicity, margin, shape, and calcification. It guides clinicians in deciding whether a biopsy or other further evaluation is needed. Machine learning (ML) can complement TI-RADS classification, thereby improving the detection of malignant tumors. When combined with expert rules (TI-RADS) and explanations, ML models may uncover elements that TI-RADS misses, especially when TI-RADS training data are scarce. In this paper, we present an automated system for classifying thyroid nodules according to TI-RADS and assessing malignancy effectively. We use ResNet-101 and DenseNet-201 models to classify thyroid nodules according to TI-RADS and malignancy. By analyzing the models' last layer using the Grad-CAM algorithm, we demonstrate that these models can identify risk areas and detect nodule features relevant to the TI-RADS score. By integrating Grad-CAM results with feature probability calculations, we provide a precise heat map, visualizing specific features within the nodule and potentially assisting doctors in their assessments. Our experiments show that the utilization of ResNet-101 and DenseNet-201 models, in conjunction with Grad-CAM visualization analysis, improves TI-RADS classification accuracy by up to 10%. This enhancement, achieved through iterative analysis and re-training, underscores the potential of machine learning in advancing thyroid nodule diagnosis, offering a promising direction for further exploration and clinical application.
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http://dx.doi.org/10.3390/s23167289 | DOI Listing |
Thyroid
January 2025
Department of Surgery, the Florida University School of Medicine, Tampa, Florida, USA.
PeerJ
January 2025
Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), i3S-Institute for Research & Innovation in Health, Porto, Portugal.
Background: The differential diagnosis between benign and malignant thyroid nodules continues to be a major challenge in clinical practice. The rising incidence of thyroid neoplasm and the low incidence of aggressive thyroid carcinoma, urges the exploration of strategies to improve the diagnostic accuracy in a pre-surgical phase, particularly for indeterminate nodules, and to prevent unnecessary surgeries. Only in 2022, the 5th WHO Classification of Endocrine and Neuroendocrine Tumors, and in 2023, the 3rd Bethesda System for Reporting Thyroid Cytopathology and the European Thyroid Association included biomarkers in their guidelines.
View Article and Find Full Text PDFCytopathology
January 2025
Department of Endocrine Surgery, University Hospital of Wales, Cardiff, UK.
Background: Traditional teaching dictated that patients with recurrent thyroid cysts undergo excision owing to a 12% risk malignancy. Ultrasound evaluation now determines management of these patients augmented by fine needle biopsy. In UK, a non-diagnostic category for thyroid cysts (Thy1c) exists, whereas the Bethesda system combines 'non-diagnostic-cyst fluid only' into Category I along with paucicellular and acellular results.
View Article and Find Full Text PDFActa Endocrinol (Buchar)
January 2025
University of Health Sciences, Gulhane Training and Research Hospital, Nuclear Medicine Department.
Contex: Detection of parathyroid incidentalomas (PTIs) by ultrasonography (US) generally depends on clinical experience and it can be usually confused with perithyroidal lymph nodes.
Objective: We aimed to evaluate the role of US for the detection of PTIs and define clinicopathologic features of PTIs detected during routine neck US.
Design: In this retrospective study, we studied PTIs in a multidisciplinary clinical approach of nuclear medicine and general surgery clinics.
J Am Soc Cytopathol
December 2024
Faculty of Medicine, Pelita Harapan University, Tangerang, Indonesia.
Introduction: The rate of nondiagnostic and indeterminate cytology findings from fine-needle aspiration biopsy (FNAB) is quite high, resulting in repeated puncture and unnecessary surgery. The primary objective of this investigation is to compare diagnostic accuracy of core-needle biopsy (CNB) with repeat FNAB for thyroid nodules with initially inconclusive (nondiagnostic and/or atypia of undetermined significance) FNAB results.
Materials And Methods: A thorough search was performed on the Cochrane Library, Scopus, Europe PMC, and Medline databases until October 20th, 2024, employing a combination of pertinent keywords.
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