Computer-Aided Diagnosis of Thyroid Nodule: A Review

ABSTRAC

Radial Basis Function Artificial Neural Network for the Investigation of Thyroid Cytological Lesions

Objective. This study investigates the potential of an artificial intelligence (AI) methodology, the radial basis function (RBF) artificial neural network (ANN), in the evaluation of thyroid lesions. Study Design. The study was performed on 447 patients who had both cytological and histological evaluation in agreement. Cytological specimens were prepared using liquid-based cytology, and the histological result was based on subsequent surgical samples. Each specimen was digitized; on these images, nuclear morphology features were measured by the use of an image analysis system. The extracted measurements (41,324 nuclei) were separated into two sets: the training set that was used to create the RBF ANN and the test set that was used to evaluate the RBF performance. The system aimed to predict the histological status as benign or malignant. Results. The RBF ANN obtained in the training set has sensitivity 82.5%, specificity 94.6%, and overall accuracy 90.3%, while in the test set, these indices were 81.4%, 90.0%, and 86.9%, respectively. Algorithm was used to classify patients on the basis of the RBF ANN, the overall sensitivity was 95.0%, the specificity was 95.5%, and no statistically significant difference was observed. Conclusion. AI techniques and especially ANNs, only in the recent years, have been studied extensively. The proposed approach is promising to avoid misdiagnoses and assists the everyday practice of the cytopathology. The major drawback in this approach is the automation of a procedure to accurately detect and measure cell nuclei from the digitized images

Construction of machine learning-based models for cancer outcomes in low and lower-middle income countries: A scoping review

Background: The impact and utility of machine learning (ML)-based prediction tools for cancer outcomes including assistive diagnosis, risk stratification, and adjunctive decision-making have been largely described and realized in the high income and upper-middle-income countries. However, statistical projections have estimated higher cancer incidence and mortality risks in low and lower-middle-income countries (LLMICs). Therefore, this review aimed to evaluate the utilization, model construction methods, and degree of implementation of ML-based models for cancer outcomes in LLMICs. Methods: PubMed/Medline, Scopus, and Web of Science databases were searched and articles describing the use of ML-based models for cancer among local populations in LLMICs between 2002 and 2022 were included. A total of 140 articles from 22,516 citations that met the eligibility criteria were included in this study. Results: ML-based models from LLMICs were often based on traditional ML algorithms than deep or deep hybrid learning. We found that the construction of ML-based models was skewed to particular LLMICs such as India, Iran, Pakistan, and Egypt with a paucity of applications in sub-Saharan Africa. Moreover, models for breast, head and neck, and brain cancer outcomes were frequently explored. Many models were deemed suboptimal according to the Prediction model Risk of Bias Assessment tool (PROBAST) due to sample size constraints and technical flaws in ML modeling even though their performance accuracy ranged from 0.65 to 1.00. While the development and internal validation were described for all models included (n=137), only 4.4% (6/137) have been validated in independent cohorts and 0.7% (1/137) have been assessed for clinical impact and efficacy. Conclusion: Overall, the application of ML for modeling cancer outcomes in LLMICs is increasing. However, model development is largely unsatisfactory. We recommend model retraining using larger sample sizes, intensified external validation practices, and increased impact assessment studies using randomized controlled trial design

ENAS-B: Combining ENAS with Bayesian Optimisation for Automatic Design of Optimal CNN Architectures for Breast Lesion Classification from Ultrasound Images

Efficient Neural Architecture Search (ENAS) is a recent development in searching for optimal cell structures for Convolutional Neural Network (CNN) design. It has been successfully used in various applications including ultrasound image classification for breast lesions. However, the existing ENAS approach only optimises cell structures rather than the whole CNN architecture nor its trainable hyperparameters. This paper presents a novel framework for automatic design of CNN architectures by combining strengths of ENAS and Bayesian Optimisation in two folds. Firstly, we use ENAS to search for optimal normal and reduction cells. Secondly, with the optimal cells and a suitable hyperparameter search space, we adopt Bayesian Optimisation to find the optimal depth of the network and optimal configuration of the trainable hyperparameters. To test the validity of the proposed framework, a dataset of 1,522 breast lesion ultrasound images is used for the searching and modelling. We then evaluate the robustness of the proposed approach by testing the optimized CNN model on three external datasets consisting of 727 benign and 506 malignant lesion images. We further compare the CNN model with the default ENAS-based CNN model, and then with CNN models based on the state-of-the-art architectures. The results (error rate of no more than 20.6% on internal tests and 17.3% on average of external tests) showed that the proposed framework generates robust and light CNN models

Differentiation of the Follicular Neoplasm on the Gray-Scale US by Image Selection Subsampling along with the Marginal Outline Using Convolutional Neural Network

We conducted differentiations between thyroid follicular adenoma and carcinoma for 8-bit bitmap ultrasonography (US) images utilizing a deep-learning approach. For the data sets, we gathered small-boxed selected images adjacent to the marginal outline of nodules and applied a convolutional neural network (CNN) to have differentiation, based on a statistical aggregation, that is, a decision by majority. From the implementation of the method, introducing a newly devised, scalable, parameterized normalization treatment, we observed meaningful aspects in various experiments, collecting evidence regarding the existence of features retained on the margin of thyroid nodules, such as 89.51% of the overall differentiation accuracy for the test data, with 93.19% of accuracy for benign adenoma and 71.05% for carcinoma, from 230 benign adenoma and 77 carcinoma US images, where we used only 39 benign adenomas and 39 carcinomas to train the CNN model, and, with these extremely small training data sets and their model, we tested 191 benign adenomas and 38 carcinomas. We present numerical results including area under receiver operating characteristic (AUROC).ope

Implementing decision tree-based algorithms in medical diagnostic decision support systems

As a branch of healthcare, medical diagnosis can be defined as finding the disease based on the signs and symptoms of the patient. To this end, the required information is gathered from different sources like physical examination, medical history and general information of the patient. Development of smart classification models for medical diagnosis is of great interest amongst the researchers. This is mainly owing to the fact that the machine learning and data mining algorithms are capable of detecting the hidden trends between features of a database. Hence, classifying the medical datasets using smart techniques paves the way to design more efficient medical diagnostic decision support systems. Several databases have been provided in the literature to investigate different aspects of diseases. As an alternative to the available diagnosis tools/methods, this research involves machine learning algorithms called Classification and Regression Tree (CART), Random Forest (RF) and Extremely Randomized Trees or Extra Trees (ET) for the development of classification models that can be implemented in computer-aided diagnosis systems. As a decision tree (DT), CART is fast to create, and it applies to both the quantitative and qualitative data. For classification problems, RF and ET employ a number of weak learners like CART to develop models for classification tasks. We employed Wisconsin Breast Cancer Database (WBCD), Z-Alizadeh Sani dataset for coronary artery disease (CAD) and the databanks gathered in Ghaem Hospital’s dermatology clinic for the response of patients having common and/or plantar warts to the cryotherapy and/or immunotherapy methods. To classify the breast cancer type based on the WBCD, the RF and ET methods were employed. It was found that the developed RF and ET models forecast the WBCD type with 100% accuracy in all cases. To choose the proper treatment approach for warts as well as the CAD diagnosis, the CART methodology was employed. The findings of the error analysis revealed that the proposed CART models for the applications of interest attain the highest precision and no literature model can rival it. The outcome of this study supports the idea that methods like CART, RF and ET not only improve the diagnosis precision, but also reduce the time and expense needed to reach a diagnosis. However, since these strategies are highly sensitive to the quality and quantity of the introduced data, more extensive databases with a greater number of independent parameters might be required for further practical implications of the developed models

Computer analysis of ultrasound images of thyroid nodules, focusing on their sonographic features and cytological findings.

Ultrazvukové zobrazování patří mezi základní vyšetření uzlů ve štítné žláze, na jejichž základě se rozhoduje, zda pacient podstoupí cytologické vyšetření, které je hlavním podkladem pro rozhodování o případném chirurgickém odstranění štítné žlázy. Cytologické vyšetření má ale bohužel omezenou specificitu a případná operace s sebou nese rizika. Proto jsou hledány další metody, které by byly schopny vnést do diagnostiky více jistoty. Jednou z nových metod je počítačová podpora diagnostiky (CAD), která pomocí analýzy obrazu a strojového učení vykazuje poměrně slibné výsledky. V této práci představujeme dva do určité míry podobné, přesto však odlišné, CAD přístupy. První přístup spočívá v analýze celých uzlů pomocí Segmentation Based Fractal Texture Analysis (SFTA) algoritmu, který rozkládá obraz na jednotlivá šedotónová pásma pomocí metody binární stack-dekompozice. Pomocí tohoto přístupu bylo na datovém souboru 40 snímků hodnocených metodou křížové validace dosaženo přesnosti 92,5 % při použití náhodných lesů a 95 % při použití support vector machines (SVM). Druhý CAD přístup vychází také z metody vícenásobného prahování obrazu, ale s tím rozdílem, že z jednotlivých šedotónových pásem je extrahováno větší množství prediktorů popisujících binární texturu a dále pak, že analýza neprobíhá na uzlu jako celku, ale...Ultrasound imaging is one of the fundamental examinations of thyroid nodules, determining whether a patient undergoes a cytological examination, which is essential for the decision on a possible thyroid surgery. Unfortunately, the cytological examination has limited specificity and potential surgery carries risks. Therefore, other diagnostic methods are being sought with hope that they will be able to bring more certainty into diagnostics. One of the new methods is computer-aided diagnosis (CAD), which exhibits promising results using image analysis and machine learning. In this study, we present two somewhat similar, yet different, CAD approaches. The first approach is based on analysing entire nodules using a Segmentation Based Fractal Texture Analysis (SFTA) algorithm that splits the image into individual grayscale bands. Using this approach, we have achieved an accuracy of 92.4% using random forests (RF) and 95% using support vector machines (SVM) on a data set of 40 images evaluated by the cross-validation method. The second CAD approach is also based on the method of multiple image thresholding, but the difference is, that a larger number of predictors describing the binary texture are extracted from the individual grayscale bands. Furthermore, the analysis did not take place on whole nodules, but on...Institute of Biophysics and Informatics First Faculty of Medicine Charles UniversityÚstav biofyziky a informatiky 1. LF UK1. lékařská fakultaFirst Faculty of Medicin