Purpose: Thyroid cancer has been a common cancer. Papillary thyroid cancer and follicular thyroid cancer are the two most common types of thyroid cancer. Follicular thyroid cancer lacks distinctive ultrasound signs and is more difficult to diagnose preoperatively than the more prevalent papillary thyroid cancer, and the clinical studies associated with it are less well established. We aimed to analyze the clinical data of follicular thyroid cancer based on a novel data mining tool to identify some clinical indications that may help in preoperative diagnosis. Methods: We performed a retrospective analysis based on case data collected by the Department of General Surgery of Peking University Third Hospital between 2010 and 2023. Unlike traditional statistical methods, we improved the association rule mining, a classical data mining method, and proposed new analytical metrics reflecting the malignant association between clinical indications and cancer with the help of the idea of SHAP method in interpretable machine learning. Results: The dataset was preprocessed to contain 1673 cases (in terms of nodes rather than patients), of which 1414 were benign and 259 were malignant nodes. Our analysis pointed out that in addition to some common indicators (e.g., irregular or lobulated nodal margins, uneven thickness halo, hypoechogenicity), there were also some indicators with strong malignant associations, such as nodule-in-nodule pattern, trabecular pattern, and low TSH scores. In addition, our results suggest that the combination of Hashimoto's thyroiditis may also have a strong malignant association. Conclusion: In the preoperative diagnosis of nodules suspected of follicular thyroid cancer, multiple clinical indications should be considered for a more accurate diagnosis. The diverse malignant associations identified in our study may serve as a reference for clinicians in related fields.

Thyroid carcinoma, a significant yet often controllable cancer, has seen a rise in cases, largely due to advancements in diagnostic methods. Differentiated thyroid cancer (DTC), which includes papillary and follicular varieties, is typically associated with a positive prognosis in academic circles. Nevertheless, there are still some individuals who may experience a recurrence. This study employs machine learning, particularly deep learning models, to predict the recurrence of DTC, with the goal of improving patient care through personalized treatment approaches. By analysing a dataset containing clinicopathological features of patients, the model achieved remarkable accuracy rates of 98% during training and 96% during testing. To improve the model's interpretability, we used techniques like LIME and Morris Sensitivity Analysis. These methods gave us valuable insights into how the model makes decisions. The results suggest that combining deep learning models with interpretability techniques can be extremely useful in quickly identifying the recurrence of thyroid cancer in patients. This can help in making informed therapeutic choices and customizing treatment approaches for individual patients.

Objective: Molecular testing (MT) classifies cytologically indeterminate thyroid nodules as benign or malignant with high sensitivity but low positive predictive value (PPV), only using molecular profiles, ignoring ultrasound (US) imaging and biopsy. We address this limitation by applying attention multiple instance learning (AMIL) to US images. Methods: We retrospectively reviewed 333 patients with indeterminate thyroid nodules at UCLA medical center (259 benign, 74 malignant). A multi-modal deep learning AMIL model was developed, combining US images and MT to classify the nodules as benign or malignant and enhance the malignancy risk stratification of MT. Results: The final AMIL model matched MT sensitivity (0.946) while significantly improving PPV (0.477 vs 0.448 for MT alone), indicating fewer false positives while maintaining high sensitivity. Conclusion: Our approach reduces false positives compared to MT while maintaining the same ability to identify positive cases, potentially reducing unnecessary benign thyroid resections in patients with indeterminate nodules.

Background We aim to use Natural Language Processing (NLP) to automate the extraction and classification of thyroid cancer risk factors from pathology reports. Methods We analyzed 1,410 surgical pathology reports from adult papillary thyroid cancer patients at Mayo Clinic, Rochester, MN, from 2010 to 2019. Structured and non-structured reports were used to create a consensus-based ground truth dictionary and categorized them into modified recurrence risk levels. Non-structured reports were narrative, while structured reports followed standardized formats. We then developed ThyroPath, a rule-based NLP pipeline, to extract and classify thyroid cancer features into risk categories. Training involved 225 reports (150 structured, 75 unstructured), with testing on 170 reports (120 structured, 50 unstructured) for evaluation. The pipeline's performance was assessed using both strict and lenient criteria for accuracy, precision, recall, and F1-score. Results In extraction tasks, ThyroPath achieved overall strict F-1 scores of 93% for structured reports and 90 for unstructured reports, covering 18 thyroid cancer pathology features. In classification tasks, ThyroPath-extracted information demonstrated an overall accuracy of 93% in categorizing reports based on their corresponding guideline-based risk of recurrence: 76.9% for high-risk, 86.8% for intermediate risk, and 100% for both low and very low-risk cases. However, ThyroPath achieved 100% accuracy across all thyroid cancer risk categories with human-extracted pathology information. Conclusions ThyroPath shows promise in automating the extraction and risk recurrence classification of thyroid pathology reports at large scale. It offers a solution to laborious manual reviews and advancing virtual registries. However, it requires further validation before implementation.

Thyroid cancer is an increasing global health concern that requires advanced diagnostic methods. The application of AI and radiomics to thyroid cancer diagnosis is examined in this review. A review of multiple databases was conducted in compliance with PRISMA guidelines until October 2023. A combination of keywords led to the discovery of an English academic publication on thyroid cancer and related subjects. 267 papers were returned from the original search after 109 duplicates were removed. Relevant studies were selected according to predetermined criteria after 124 articles were eliminated based on an examination of their abstract and title. After the comprehensive analysis, an additional six studies were excluded. Among the 28 included studies, radiomics analysis, which incorporates ultrasound (US) images, demonstrated its effectiveness in diagnosing thyroid cancer. Various results were noted, some of the studies presenting new strategies that outperformed the status quo. The literature has emphasized various challenges faced by AI models, including interpretability issues, dataset constraints, and operator dependence. The synthesized findings of the 28 included studies mentioned the need for standardization efforts and prospective multicenter studies to address these concerns. Furthermore, approaches to overcome these obstacles were identified, such as advances in explainable AI technology and personalized medicine techniques. The review focuses on how AI and radiomics could transform the diagnosis and treatment of thyroid cancer. Despite challenges, future research on multidisciplinary cooperation, clinical applicability validation, and algorithm improvement holds the potential to improve patient outcomes and diagnostic precision in the treatment of thyroid cancer.

Thyroid cancer, the most prevalent endocrine cancer, has gained significant global attention due to its impact on public health. Extensive research efforts have been dedicated to leveraging artificial intelligence (AI) methods for the early detection of this disease, aiming to reduce its morbidity rates. However, a comprehensive understanding of the structured organization of research applications in this particular field remains elusive. To address this knowledge gap, we conducted a systematic review and developed a comprehensive taxonomy of machine learning-based applications in thyroid cancer pathogenesis, diagnosis, and prognosis. Our primary objective was to facilitate the research community's ability to stay abreast of technological advancements and potentially lead the emerging trends in this field. This survey presents a coherent literature review framework for interpreting the advanced techniques used in thyroid cancer research. A total of 758 related studies were identified and scrutinized. To the best of our knowledge, this is the first review that provides an in-depth analysis of the various aspects of AI applications employed in the context of thyroid cancer. Furthermore, we highlight key challenges encountered in this domain and propose future research opportunities for those interested in studying the latest trends or exploring less-investigated aspects of thyroid cancer research. By presenting this comprehensive review and taxonomy, we contribute to the existing knowledge in the field, while providing valuable insights for researchers, clinicians, and stakeholders in advancing the understanding and management of this disease.

There has been a growing interest in creating intelligent diagnostic systems to assist medical professionals in analyzing and processing big data for the treatment of incurable diseases. One of the key challenges in this field is detecting thyroid cancer, where advancements have been made using machine learning (ML) and big data analytics to evaluate thyroid cancer prognosis and determine a patient's risk of malignancy. This review paper summarizes a large collection of articles related to artificial intelligence (AI)-based techniques used in the diagnosis of thyroid cancer. Accordingly, a new classification was introduced to classify these techniques based on the AI algorithms used, the purpose of the framework, and the computing platforms used. Additionally, this study compares existing thyroid cancer datasets based on their features. The focus of this study is on how AI-based tools can support the diagnosis and treatment of thyroid cancer, through supervised, unsupervised, or hybrid techniques. It also highlights the progress made and the unresolved challenges in this field. Finally, the future trends and areas of focus in this field are discussed.

However, the characteristics of thyroid nodules are often documented in clinical narratives such as ultrasound reports. Previous studies have examined natural language processing (NLP) methods in extracting a limited number of characteristics (<9) using rule-based NLP systems. In this study, a multidisciplinary team of NLP experts and thyroid specialists, identified thyroid nodule characteristics that are important for clinical care, composed annotation guidelines, developed a corpus, and compared 5 state-of-the-art transformer-based NLP methods, including BERT, RoBERTa, LongFormer, DeBERTa, and GatorTron, for extraction of thyroid nodule characteristics from ultrasound reports. Our GatorTron model, a transformer-based large language model trained using over 90 billion words of text, achieved the best strict and lenient F1-score of 0.8851 and 0.9495 for the extraction of a total number of 16 thyroid nodule characteristics, and 0.9321 for linking characteristics to nodules, outperforming other clinical transformer models. To the best of our knowledge, this is the first study to systematically categorize and apply transformer-based NLP models to extract a large number of clinical relevant thyroid nodule characteristics from ultrasound reports. This study lays ground for assessing the documentation quality of thyroid ultrasound reports and examining outcomes of patients with thyroid nodules using electronic health records. Introduction Thyroid cancer overdiagnosis is common, harmful, and costly. More than 44,000 new cases of thyroid cancer are expected in the US in 2022.

The epidemiological characteristics and clinical examination methods of thyroid nodules: Thyroid nodules are widespread clinically, and the incidence continues to rise worldwide, with an autopsy study estimating that 50% to 60% of adults may have thyroid nodules (1, 2). High-resolution ultrasound (US) can detect thyroid nodules in 19%- 68% (3) of randomly selected individuals, of which thyroid cancer occurs in 7% to 15% (4). Thyroid cancer is the most common endocrine malignancy in the United States (5) and the fifth most common cancer among women (6). The benign thyroid nodules without surgical indications generally do not require special treatment. In contrast, malignant thyroid nodules should be elective surgical treatment once diagnosed, and neck dissection should be performed if lymph node metastases are present. Some patients need to be treated with Iodine-131 nuclide after the operation (7) and predict the prognosis. Papillary thyroid carcinoma (PTC) is the most common pathological type of thyroid cancer. It usually has a good prognosis, but relapse patients have a poor prognosis. About 10%-15% of PTC will relapse, and recurrent PTC has aggressive characteristics such as extra-thyroid extension (ETE), invasive cell subtypes, lateral neck lymphatic metastasis, resistance to therapy, and distant metastases (8). The challenge for clinicians is to balance treatment approaches so that patients with low-risk or benign thyroid nodules are not over-treated, while patients with high-risk or malignant thyroid nodules need more aggressive therapies. Therefore, the differential diagnosis of thyroid nodules and the risk stratification are essential and helpful for the subsequent individualized treatment.

The incidence of thyroid cancer is rising steadily because of overdiagnosis and overtreatment conferred by widespread use of sensitive imaging techniques for screening. This overall incidence growth is especially driven by increased diagnosis of indolent and well-differentiated papillary subtype and early-stage thyroid cancer, whereas the incidence of advanced-stage thyroid cancer has increased marginally. Thyroid ultrasound is frequently used to diagnose thyroid cancer. The aim of this study was to use deep convolutional neural network (DCNN) models to improve the diagnostic accuracy of thyroid cancer by analysing sonographic imaging data from clinical ultrasounds.