Computer-aided diagnosis (CAD) systems hold potential to improve the diagnostic accuracy of thyroid ultrasound (US). We aimed to develop a deep learning-based US CAD system (dCAD) for the diagnosis of thyroid nodules and compare its performance with those of a support vector machine (SVM)-based US CAD system (sCAD) and radiologists. dCAD was developed by using US images of 4919 thyroid nodules from three institutions. Its diagnostic performance was prospectively evaluated between June 2016 and February 2017 in 286 nodules, and was compared with those of sCAD and radiologists, using logistic regression with the generalized estimating equation. Subgroup analyses were performed according to experience level and separately for small thyroid nodules 1–2 cm. There was no difference in overall sensitivity, specificity, positive predictive value (PPV), negative predictive value and accuracy (all p > 0.05) between radiologists and dCAD. Radiologists and dCAD showed higher specificity, PPV, and accuracy than sCAD (all p < 0.001). In small nodules, experienced radiologists showed higher specificity, PPV and accuracy than sCAD (all p < 0.05). In conclusion, dCAD showed overall comparable diagnostic performance with radiologists and assessed thyroid nodules more effectively than sCAD, without loss of sensitivity.

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Reviews of the most recent applications of deep learning on ultrasound imaging applications are presented. Architectures of deep learning networks are briefly explained for medical imaging application categories of classification, detection, segmentation, and generation. Ultrasonography applications are then reviewed and summarized for image processing and diagnosis along with some representative study cases of breast, thyroid, heart, kidney, liver, and fetal head. Efforts on workflow enhancement are also reviewed with emphasis on view recognition, scanning guide, image quality assessment, and quantification and measurement. Finally some future prospects are presented on image quality Enhancement, diagnostic support, and improving workflow efficiency, along with remarks on hurdles, benefits, and necessary collaborations.

In this paper, we propose novel feature extraction techniques which can provide a high accuracy rate of mass classification in the computer-aided lesion diagnosis of breast tumor. Totally 290 features were extracted using the newly developed border irregularity feature extractor as well as multiple sonographic features based on the breast imaging-reporting and data system (BI-RADS) lexicons. To demonstrate the performance of the proposed features, 4,107 ultrasound images containing 2,508 malignant cases were used. The clinical results demonstrate that the proposed feature combination can be an integral part of ultrasound CAD systems to help accurately distinguish benign from malignant tumors.

Abstract. The implementation of lesion segmentation for breast ultrasound image relies on several diagnostic rules on intensity, texture, etc. In this paper, we propose a novel algorithm to achieve a comprehensive decision upon these rules by incorporating image over-segmentation and lesion detection in a pairwise CRF model, rather than a term-byterm translation. Multiple detection hypotheses are used to propagate object-level cues to segments and a unified classifier is trained based on the concatenated features. The experimental results show that our algorithm can avoid the drawbacks of separate detection or bottom-up segmentation, and can deal with very complicated cases.