Convolutional Neural Network-Based Computer-Assisted Diagnosis of Hashimoto’s Thyroiditis on Ultrasound

PURPOSE: This study investigates the efficiency of deep learning models in the automated diagnosis of Hashimoto’s thyroiditis (HT) using real-world ultrasound data from ultrasound examinations by computer-assisted diagnosis (CAD) with artificial intelligence. METHODS: We retrospectively collected ultrasound images from patients with and without HT from 2 hospitals in China between September 2008 and February 2018. Images were divided into a training set (80%) and a validation set (20%). We ensembled 9 convolutional neural networks (CNNs) as the final model (CAD-HT) for HT classification. The model’s diagnostic performance was validated and compared to 2 hospital validation sets. We also compared the accuracy of CAD-HT against seniors/junior radiologists. Subgroup analysis of CAD-HT performance for different thyroid hormone levels (hyperthyroidism, hypothyroidism, and euthyroidism) was also evaluated. RESULTS: 39 280 ultrasound images from 21 118 patients were included in this study. The accuracy, sensitivity, and specificity of the HT-CAD model were 0.892, 0.890, and 0.895, respectively. HT-CAD performance between 2 hospitals was not significantly different. The HT-CAD model achieved a higher performance (P < 0.001) when compared to senior radiologists, with a nearly 9% accuracy improvement. HT-CAD had almost similar accuracy (range 0.87-0.894) for the 3 subgroups based on thyroid hormone level. CONCLUSION: The HT-CAD strategy based on CNN significantly improved the radiologists’ diagnostic accuracy of HT. Our model demonstrates good performance and robustness in different hospitals and for different thyroid hormone levels.