Computer-Aided Diagnosis of Thyroid Nodule: A Review

ABSTRAC

Adaptive Feature Engineering Modeling for Ultrasound Image Classification for Decision Support

Ultrasonography is considered a relatively safe option for the diagnosis of benign and malignant cancer lesions due to the low-energy sound waves used. However, the visual interpretation of the ultrasound images is time-consuming and usually has high false alerts due to speckle noise. Improved methods of collection image-based data have been proposed to reduce noise in the images; however, this has proved not to solve the problem due to the complex nature of images and the exponential growth of biomedical datasets. Secondly, the target class in real-world biomedical datasets, that is the focus of interest of a biopsy, is usually significantly underrepresented compared to the non-target class. This makes it difficult to train standard classification models like Support Vector Machine (SVM), Decision Trees, and Nearest Neighbor techniques on biomedical datasets because they assume an equal class distribution or an equal misclassification cost. Resampling techniques by either oversampling the minority class or under-sampling the majority class have been proposed to mitigate the class imbalance problem but with minimal success. We propose a method of resolving the class imbalance problem with the design of a novel data-adaptive feature engineering model for extracting, selecting, and transforming textural features into a feature space that is inherently relevant to the application domain. We hypothesize that by maximizing the variance and preserving as much variability in well-engineered features prior to applying a classifier model will boost the differentiation of the thyroid nodules (benign or malignant) through effective model building. Our proposed a hybrid approach of applying Regression and Rule-Based techniques to build our Feature Engineering and a Bayesian Classifier respectively. In the Feature Engineering model, we transformed images pixel intensity values into a high dimensional structured dataset and fitting a regression analysis model to estimate relevant kernel parameters to be applied to the proposed filter method. We adopted an Elastic Net Regularization path to control the maximum log-likelihood estimation of the Regression model. Finally, we applied a Bayesian network inference to estimate a subset for the textural features with a significant conditional dependency in the classification of the thyroid lesion. This is performed to establish the conditional influence on the textural feature to the random factors generated through our feature engineering model and to evaluate the success criterion of our approach. The proposed approach was tested and evaluated on a public dataset obtained from thyroid cancer ultrasound diagnostic data. The analyses of the results showed that the classification performance had a significant improvement overall for accuracy and area under the curve when then proposed feature engineering model was applied to the data. We show that a high performance of 96.00% accuracy with a sensitivity and specificity of 99.64%) and 90.23% respectively was achieved for a filter size of 13 × 13

Hypothyroidism

Hypothyroidism is an endocrine disorder commonly caused by Hashimoto’s disease. Nowadays, autoimmune diseases appear to be on the rise. As such, there is renewed interest in hypothyroidism. This book presents a comprehensive overview of the disorder with chapters on etiology and pathogenesis, precision medicine tools for detection, diagnosis and treatment, the morphology of the thyroid gland, the effect of hypothyroidism on various organ systems, and much more

Radiomics in [¹⁸F]FDG PET/CT:A leap in the dark?

Positron emission tomography (PET) imaging with the non-metabolisable glucose analogue 2-[18F]fluoro-2-deoxy-D-glucose ([18F]FDG), combined with low dose computed tomography (CT) for anatomical reference, is an important tool to detect and stage cancer or active inflammations. Visual interpretation of PET/CT images consists of (qualitative) assessment of radiotracer uptake in different tissues and their density. Furthermore, the location, size, shape, and relation with surrounding tissues of these lesions provide important clues on their nature. Yet, medical images contain much more information about tissue biology hidden in the myriad of voxels of both lesions and healthy tissue than can be assessed visually. Quantification of radiotracer uptake heterogeneity and other tissue characteristics is studied in the field of radiomics. Radiomics is a form of medical image processing that aims to find stable and clinically relevant image-derived biomarkers for lesion characterisation, prognostic stratification, and response prediction, thereby contributing to precision medicine. Radiomics consists of the conversion of (parts of) medical images into a high-dimensional set of quantitative features and the subsequent mining of this dataset for potential information useful for the quantification or monitoring of tumour or disease characteristics in clinical practice. This thesis contributed to a deeper understanding of the methodological aspects of handcrafted radiomics in [18F]FDG PET/CT, specifically in small datasets. However, most radiomic papers present proof-of-concept studies and clinical implementation is still far away. At some point in the future, radiomic biomarkers may be used in clinical practice, but at the moment we should acknowledge the limitations of the field and try to overcome these. Only then, we will be able to cross the translational gap towards clinical readiness. Future research should focus on standardisation of feature selection, model building, and ideally a tool that implements these aspects. In such a way, radiomics may redeem the promise of bringing forth imaging biomarkers that contribute to precision medicine.<br/

Risk Stratification of Thyroid Nodule: From Ultrasound Features to TIRADS

Since the 1990s, ultrasound (US) has played a major role in the assessment of thyroid nodules and their risk of malignancy. Over the last decade, the most eminent international societies have published US-based systems for the risk stratification of thyroid lesions, namely, Thyroid Imaging Reporting And Data Systems (TIRADSs). The introduction of TIRADSs into clinical practice has significantly increased the diagnostic power of US to a level approaching that of fine-needle aspiration cytology (FNAC). At present, we are probably approaching a new era in which US could be the primary tool to diagnose thyroid cancer. However, before using US in this new dominant role, we need further proof. This Special Issue, which includes reviews and original articles, aims to pave the way for the future in the field of thyroid US. Highly experienced thyroidologists focused on US are asked to contribute to achieve this goal

Nerve Detection in Ultrasound Images Using Median Gabor Binary Pattern

International audienceUltrasound in regional anesthesia (RA) has increased in pop-ularity over the last years. The nerve localization presents a key step for RA practice, it is therefore valuable to develop a tool able to facilitate this practice. The nerve detection in the ultrasound images is a challeng-ing task, since the noise and other artifacts corrupt the visual properties of such kind of tissue. In this paper we propose a new method to address this problem. The proposed technique operates in two steps. As the me-dian nerve belongs to a hyperechoic region, the first step consists in the segmentation of this type of region using the k-means algorithm. The second step is more critical; it deals with nerve structure detection in noisy data. For that purpose, a new descriptor is developed. It combines tow methods median binary pattern (MBP) and Gabor filter to obtain the median Gabor binary pattern (MGBP). The method was tested on 173 ultrasound images of the median nerve obtained from three patients. The results showed that the proposed approach achieves better accuracy than the original MBP, Gabor descriptor and other popular descriptors

Enter the matrix:On how to improve thyroid nodule management using 3D ultrasound

Roughly two-thirds of the adult population has a thyroid nodule, of which 90% are benign. Of the adults that have a nodule, approximately 5% will experience symptoms that include a feeling of a marble stuck in the throat, difficulty swallowing and breathing, and cosmetic complaints. Thyroid nodule management primarily makes use of ultrasound as the imaging modality for diagnosis, image guidance during therapy (radiofrequency ablation i.e. RFA), and follow-up. Although ultrasound is relatively easy to apply, it is hard to standardize for repeated measurements and across various users. Further, RFA can benefit from 3D imaging information and a planning and navigation system to improve clinical outcome. These challenges may be overcome by using 3D ultrasound. In this thesis, two phantoms were created on which these methods can be developed. Further, it offers insight into the use of 2D and 3D ultrasound for thyroid nodule management.To assess the impact of changes to an intervention, a baseline was determined of the effectiveness of RFA in Dutch hospitalsUsing a simple phantom, we have shown that utilizing a volume-based measurement technique, that the matrix transducer offers, results in improved measurement accuracy. The more complex, anthropomorphic, phantom serves as a platform on which thermal treatments, such as RFA, can be improved. Using this phantom, we have shown that the impact of 2D and 3D ultrasound on RFA efficacy does not differ from one another; however, the matrix transducer might be more user-friendly for needle placement due to the dual-plane imaging. An additional use case for these phantoms is their capacity to compare dominant and non-dominant hand ablations, as well as serve as a training platform. Additional research is required that employs more operators to find stronger evidence supporting a difference between the ablating hands and the difference in effect of 2D and 3D ultrasound guidance.To make full use of 3D ultrasound, stitching algorithms should be integrated into the ultrasound systems to acquire larger volumes. These can then be processed by deep-learning algorithms for use in computer-aided diagnosis and intervention systems. To further improve the applicability of 3D ultrasound in the clinic, integrating analysis methods such as 3D elastography and 3D Doppler is suggested