Comparison of diagnostic accuracy and utility of artificial intelligence–optimized ACR TI-RADS and original ACR TI-RADS: a multi-center validation study based on 2061 thyroid nodules

医学 甲状腺结节 神经组阅片室 放射科 结核(地质) 细针穿刺 超声波 接收机工作特性 双雷达 甲状腺 组内相关 介入放射学 核医学 活检 癌症 乳腺摄影术 内科学 乳腺癌 古生物学 心理测量学 精神科 生物 临床心理学 神经学
作者
Ying Liu,Xiaoxian Li,Cuiju Yan,Longzhong Liu,Ying Liao,Hongyan Zeng,Weijun Huang,Qian Li,Nansheng Tao,Jianhua Zhou
出处
期刊:European Radiology [Springer Science+Business Media]
卷期号:32 (11): 7733-7742 被引量:18
标识
DOI:10.1007/s00330-022-08827-y
摘要

To determine if artificial intelligence-based modification of the Thyroid Imaging Reporting Data System (TI-RADS) would be better than the current American College of Radiology (ACR) TI-RADS for risk stratification of thyroid nodules.A total of 2061 thyroid nodules (in 1859 patients) sampled with fine-needle aspiration or operation were retrospectively analyzed between January 2017 and July 2020. Two radiologists blinded to the pathologic diagnosis evaluated nodule features in five ultrasound categories and assigned TI-RADS scores by both ACR TI-RADS and AI TI-RADS. Inter-rater agreement was assessed by asking another two radiologists to score a set of 100 nodules independently. The reference standard was postoperative pathological or cytopathological diagnosis according to the Bethesda system. Inter-rater agreement was determined using intraclass correlation coefficient (ICC).AI TI-RADS assigned lower TI-RADS risk levels than ACR TI-RADS (p < 0.001) and had larger area under receiver operating characteristic curve (0.762 vs. 0.679, p < 0.001). The sensitivities of ACR TI-RADS and AI TI-RADS were similar (86.7% vs. 82.2%, p = 0.052), but specificity was higher with AI TI-RADS (70.2% vs. 49.2%, p < 0.001). AI TI-RADS downgraded 743 (48.63%) benign nodules, indicating that 328 (42.3% of 776 biopsied nodules) unnecessary fine-needle aspirations (FNA) could have been avoided. Inter-rater agreement was better with AI TI-RADS than with ACR TI-RADS (ICC, 0.808 vs. 0.861, p < 0.001).AI TI-RADS can achieve meaningful reduction in the number of benign thyroid nodules recommended for biopsy and significantly improve specificity despite a slight decrease in sensitivity.• AI TI-RADS assigned lower TI-RADS risk levels than ACR TI-RADS, showing similar sensitivity but higher specificity. • Half of the benign nodules can be downgraded of which 42.3% of biopsy nodules avoided unnecessary fine-needle aspiration (FNA). • AI TI-RADS had a better overall inter-rater agreement.
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