A Clinical Assessment of an Ultrasound Computer-Aided Diagnosis System in Differentiating Thyroid Nodules With Radiologists of Different Diagnostic Experience

INTRODUCTION: This study aimed to assess the diagnostic performance and the added value to radiologists of different levels of a computer-aided diagnosis (CAD) system for the detection of thyroid cancers. METHODS: 303 patients who underwent thyroidectomy from October 2018 to July 2019 were retrospectively reviewed. The diagnostic performance of the senior radiologist, the junior radiologist, and the CAD system were compared. The added value of the CAD system was assessed and subgroup analyses were performed according to the size of thyroid nodules. RESULTS: In total, 186 malignant thyroid nodules, and 179 benign thyroid nodules were included; 168 were papillary thyroid carcinoma (PTC), 7 were medullary thyroid carcinoma (MTC), 11 were follicular carcinoma (FTC), 127 were follicular adenoma (FA) and 52 were nodular goiters. The CAD system showed a comparable specificity as the senior radiologist (86.0% vs. 86.0%, p > 0.99), but a lower sensitivity and a lower area under the receiver operating characteristic (AUROC) curve (sensitivity: 71.5% vs. 95.2%, p < 0.001; AUROC: 0.788 vs. 0.906, p < 0.001). The CAD system improved the diagnostic sensitivities of both the senior and the junior radiologists (97.8% vs. 95.2%, p = 0.063; 88.2% vs. 75.3%, p < 0.001). CONCLUSION: The use of the CAD system using artificial intelligence is a potential tool to distinguish malignant thyroid nodules and is preferable to serve as a second opinion for less experienced radiologists to improve their diagnosis performance.