La radiologia medica

, Volume 124, Issue 2, pp 118–125 | Cite as

A computer-aided diagnosis system for the assessment and characterization of low-to-high suspicion thyroid nodules on ultrasound

  • Salvatore GittoEmail author
  • Giorgia Grassi
  • Chiara De Angelis
  • Cristian Giuseppe Monaco
  • Silvana Sdao
  • Francesco Sardanelli
  • Luca Maria Sconfienza
  • Giovanni Mauri


Aim of the study

To compare the diagnostic performance of a commercially available computer-aided diagnosis (CAD) system for thyroid ultrasound (US) with that of a non-computer-aided radiologist in the characterization of low-to-high suspicion thyroid nodules.


This retrospective study included a consecutive series of adult patients referred for US-guided fine-needle aspiration biopsy (FNAB) of a thyroid nodule. All patients were eligible for thyroid nodule FNAB according to the current international guidelines. An interventional radiologist experienced in thyroid imaging acquired the US images subsequently used for post-processing, performed FNAB and provided the US features of each nodule. A radiology resident and an endocrinology resident in consensus performed post-processing using the CAD system to assess the same nodule characteristics. The diagnostic performance and agreement of US features between the CAD system and the radiologist were compared.


Sixty-two patients (50 F; age 60 ± 12 years) were enrolled: 77.4% (48/62) of thyroid nodules were benign, 22.6% (14/62) were undetermined to malignant and required follow-up or surgery. Interobserver agreement between the CAD system and the radiologist was substantial for orientation (K = 0.69), fair for composition (K = 0.36), echogenicity (K = 0.36), K-TIRADS (K = 0.29), and slight for margins (K = 0.03). The radiologist demonstrated a significantly higher sensitivity than the CAD system (78.6% vs. 21.4%; P = 0.008), while there was no statistical difference in specificity (66.7% vs. 81.3%; P = 0.065).


This CAD system is less sensitive than an experienced radiologist and showed slight-to-substantial agreement with the radiologist for the characterization of thyroid nodules. Although it is an innovative tool with good potential, additional efforts are needed to improve its diagnostic performance.


Computer-aided diagnosis Nodule Thyroid Ultrasound 


Compliance with ethical standards

Conflict of interest

All authors declare that the have no conflict of interest.

Ethical standards

All human and animal studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.


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Copyright information

© Italian Society of Medical Radiology 2018

Authors and Affiliations

  • Salvatore Gitto
    • 1
    Email author
  • Giorgia Grassi
    • 2
  • Chiara De Angelis
    • 1
  • Cristian Giuseppe Monaco
    • 1
  • Silvana Sdao
    • 3
  • Francesco Sardanelli
    • 4
    • 5
  • Luca Maria Sconfienza
    • 5
    • 6
  • Giovanni Mauri
    • 7
  1. 1.Scuola di Specializzazione in RadiodiagnosticaUniversità degli Studi di MilanoMilanItaly
  2. 2.Scuola di Specializzazione in Endocrinologia e Malattie del MetabolismoUniversità degli Studi di MilanoMilanItaly
  3. 3.Fondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
  4. 4.Servizio di Radiologia, IRCCS Policlinico San DonatoSan Donato MilaneseItaly
  5. 5.Dipartimento di Scienze Biomediche per la SaluteUniversità degli Studi di MilanoMilanItaly
  6. 6.Unità Operativa di Radiologia Diagnostica ed InterventisticaIRCCS Istituto Ortopedico GaleazziMilanItaly
  7. 7.Divisione di Radiologia InterventisticaIEO, Istituto Europeo di Oncologia IRCCSMilanoItaly

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