Accuracy of Ultrasound Diagnosis of Thyroid Nodules Based on Artificial Intelligence-Assisted Diagnostic Technology: A Systematic Review and Meta-Analysis

Background. Ultrasonography (US) is the most common method of identifying thyroid nodules, but US images require an experienced surgeon for identification. Many artificial intelligence (AI) techniques such as computer-aided diagnostic systems (CAD), deep learning (DL), and machine learning (ML) have...

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Main Authors: Yu Xue, Ying Zhou, Tingrui Wang, Huijuan Chen, Lingling Wu, Huayun Ling, Hong Wang, Lijuan Qiu, Dongqing Ye, Bin Wang
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:International Journal of Endocrinology
Online Access:http://dx.doi.org/10.1155/2022/9492056
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author Yu Xue
Ying Zhou
Tingrui Wang
Huijuan Chen
Lingling Wu
Huayun Ling
Hong Wang
Lijuan Qiu
Dongqing Ye
Bin Wang
author_facet Yu Xue
Ying Zhou
Tingrui Wang
Huijuan Chen
Lingling Wu
Huayun Ling
Hong Wang
Lijuan Qiu
Dongqing Ye
Bin Wang
author_sort Yu Xue
collection DOAJ
description Background. Ultrasonography (US) is the most common method of identifying thyroid nodules, but US images require an experienced surgeon for identification. Many artificial intelligence (AI) techniques such as computer-aided diagnostic systems (CAD), deep learning (DL), and machine learning (ML) have been used to assist in the diagnosis of thyroid nodules, but whether AI techniques can improve the diagnostic accuracy of thyroid nodules still needs to be explored. Objective. To clarify the accuracy of AI-based thyroid nodule US images for differentiating benign and malignant thyroid nodules. Methods. A search strategy of “subject terms + key words” was used to search PubMed, Cochrane Library, Embase, Web of Science, China Biology Medicine (CBM), and China National Knowledge Infrastructure (CNKI) for studies on AI-assisted diagnosis of thyroid nodules based on US images. The summarized receiver operating characteristic (SROC) curve and the pooled sensitivity and specificity were used to assess the performance of the diagnostic tests. The quality assessment of diagnostics accuracy studies-2 (QUADAS-2) tool was used to assess the methodological quality of the included studies. The Review Manager 5.3 and Stata 15 were used to process the data. Subgroup analysis was based on the integrity of data collection. Results. A total of 25 studies with 17,429 US images of thyroid nodules were included. AI-assisted diagnostic techniques had better diagnostic efficacy in the diagnosis of benign and malignant thyroid nodules: sensitivity 0.88 (95% CI: (0.85–0.90)), specificity 0.81 (95% CI: 0.74–0.86), diagnostic odds ratio (DOR) 30 (95% CI: 19–46). The SROC curve indicated that the area under the curve (AUC) was 0.92 (95% CI: 0.89–0.94). Threshold effect analysis showed a Spearman correlation coefficient: 0.17 < 0.5, suggesting no threshold effect for the included studies. After a meta-regression analysis of 4 different subgroups, the results showed a statistically significant effect of mean age ≥50 years on heterogeneity. Compared with studies with an average age of ≥50 years, AI-assisted diagnostic techniques had higher diagnostic performance in studies with an average age of <50 years (0.89 (95% CI: 0.87–0.92) vs. 0.80 (95% CI: 0.73–0.88)), (0.83 (95% CI: 0.77–0.88) vs. 0.73 (95% CI: 0.60–0.87)). Conclusions. AI-assisted diagnostic techniques had good diagnostic efficacy for thyroid nodules. For the diagnosis of <50 year olds, AI-assisted diagnostic technology was more effective in diagnosis.
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spelling doaj-art-91ce819f20324915bdf2d69724f834482025-08-20T02:10:01ZengWileyInternational Journal of Endocrinology1687-83452022-01-01202210.1155/2022/9492056Accuracy of Ultrasound Diagnosis of Thyroid Nodules Based on Artificial Intelligence-Assisted Diagnostic Technology: A Systematic Review and Meta-AnalysisYu Xue0Ying Zhou1Tingrui Wang2Huijuan Chen3Lingling Wu4Huayun Ling5Hong Wang6Lijuan Qiu7Dongqing Ye8Bin Wang9Department of Epidemiology and BiostatisticsDepartment of Epidemiology and BiostatisticsDepartment of Epidemiology and BiostatisticsDepartment of Epidemiology and BiostatisticsDepartment of Epidemiology and BiostatisticsDepartment of Epidemiology and BiostatisticsDepartment of Epidemiology and BiostatisticsDepartment of Epidemiology and BiostatisticsDepartment of Epidemiology and BiostatisticsDepartment of Epidemiology and BiostatisticsBackground. Ultrasonography (US) is the most common method of identifying thyroid nodules, but US images require an experienced surgeon for identification. Many artificial intelligence (AI) techniques such as computer-aided diagnostic systems (CAD), deep learning (DL), and machine learning (ML) have been used to assist in the diagnosis of thyroid nodules, but whether AI techniques can improve the diagnostic accuracy of thyroid nodules still needs to be explored. Objective. To clarify the accuracy of AI-based thyroid nodule US images for differentiating benign and malignant thyroid nodules. Methods. A search strategy of “subject terms + key words” was used to search PubMed, Cochrane Library, Embase, Web of Science, China Biology Medicine (CBM), and China National Knowledge Infrastructure (CNKI) for studies on AI-assisted diagnosis of thyroid nodules based on US images. The summarized receiver operating characteristic (SROC) curve and the pooled sensitivity and specificity were used to assess the performance of the diagnostic tests. The quality assessment of diagnostics accuracy studies-2 (QUADAS-2) tool was used to assess the methodological quality of the included studies. The Review Manager 5.3 and Stata 15 were used to process the data. Subgroup analysis was based on the integrity of data collection. Results. A total of 25 studies with 17,429 US images of thyroid nodules were included. AI-assisted diagnostic techniques had better diagnostic efficacy in the diagnosis of benign and malignant thyroid nodules: sensitivity 0.88 (95% CI: (0.85–0.90)), specificity 0.81 (95% CI: 0.74–0.86), diagnostic odds ratio (DOR) 30 (95% CI: 19–46). The SROC curve indicated that the area under the curve (AUC) was 0.92 (95% CI: 0.89–0.94). Threshold effect analysis showed a Spearman correlation coefficient: 0.17 < 0.5, suggesting no threshold effect for the included studies. After a meta-regression analysis of 4 different subgroups, the results showed a statistically significant effect of mean age ≥50 years on heterogeneity. Compared with studies with an average age of ≥50 years, AI-assisted diagnostic techniques had higher diagnostic performance in studies with an average age of <50 years (0.89 (95% CI: 0.87–0.92) vs. 0.80 (95% CI: 0.73–0.88)), (0.83 (95% CI: 0.77–0.88) vs. 0.73 (95% CI: 0.60–0.87)). Conclusions. AI-assisted diagnostic techniques had good diagnostic efficacy for thyroid nodules. For the diagnosis of <50 year olds, AI-assisted diagnostic technology was more effective in diagnosis.http://dx.doi.org/10.1155/2022/9492056
spellingShingle Yu Xue
Ying Zhou
Tingrui Wang
Huijuan Chen
Lingling Wu
Huayun Ling
Hong Wang
Lijuan Qiu
Dongqing Ye
Bin Wang
Accuracy of Ultrasound Diagnosis of Thyroid Nodules Based on Artificial Intelligence-Assisted Diagnostic Technology: A Systematic Review and Meta-Analysis
International Journal of Endocrinology
title Accuracy of Ultrasound Diagnosis of Thyroid Nodules Based on Artificial Intelligence-Assisted Diagnostic Technology: A Systematic Review and Meta-Analysis
title_full Accuracy of Ultrasound Diagnosis of Thyroid Nodules Based on Artificial Intelligence-Assisted Diagnostic Technology: A Systematic Review and Meta-Analysis
title_fullStr Accuracy of Ultrasound Diagnosis of Thyroid Nodules Based on Artificial Intelligence-Assisted Diagnostic Technology: A Systematic Review and Meta-Analysis
title_full_unstemmed Accuracy of Ultrasound Diagnosis of Thyroid Nodules Based on Artificial Intelligence-Assisted Diagnostic Technology: A Systematic Review and Meta-Analysis
title_short Accuracy of Ultrasound Diagnosis of Thyroid Nodules Based on Artificial Intelligence-Assisted Diagnostic Technology: A Systematic Review and Meta-Analysis
title_sort accuracy of ultrasound diagnosis of thyroid nodules based on artificial intelligence assisted diagnostic technology a systematic review and meta analysis
url http://dx.doi.org/10.1155/2022/9492056
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