Artificial Intelligence for Evaluation of Thyroid Nodules: A Primer

Background: Artificial intelligence (AI) is broadly defined as the ability of machines to apply human-like reasoning to problem solving. Recent years have seen a rapid growth of AI in many disciplines. This review will focus on AI applications in the assessment of thyroid nodules. Summary: AI encompasses two related computational techniques: machine learning, in which computers learn by observing data provided by humans, and deep learning, which employs neural networks that mimic brain structure and function to analyze data. Some experts believe the way AI systems reach a conclusion should be transparent, or explainable, while others disagree. Most AI platforms in thyroid disease have focused on malignancy risk stratification of nodules. To date, four have been approved by the United States Food and Drug Administration. While the results of validation studies have been mixed, there is ample evidence that AI can exceed the performance of some humans, particularly physicians with less experience. AI has also been applied to assessment of lymph nodes and cytopathology specimens. Conclusions: Adoption of AI in thyroid disease will require vendors to demonstrate that their software works as intended, is readily usable in real-world settings, and is cost effective. AI platforms that perform best in head-to-head comparisons will dominate and spur wider adoption.