人工智能在甲状腺癌诊断中的应用:最新进展和未来发展方向

Lakshmi Nagendra, Joseph M Pappachan, C. Fernandez
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摘要

尽管出现了创新的诊断、手术和化疗方式,甲状腺癌的诊断和治疗仍充满挑战。预测不准确、细胞病理学诊断不确定、滤泡性肿瘤鉴别困难、超声成像观察者内部和观察者之间的差异等挑战阻碍了甲状腺癌的个性化治疗。在分析技术快速发展的推动下,人工智能(AI)正在为医疗保健带来范式转变。最近的几项研究显示,基于人工智能辅助算法的甲状腺癌诊断取得了显著进展。人工智能技术在甲状腺超声检查和细胞病理学中的应用,在敏感性和特异性上都比传统诊断方式有了显著提高。人工智能也被用于不确定结节的治疗算法的开发和甲状腺癌患者的预后。人工智能在甲状腺癌管理中的高可重复性和直接实施的好处表明它具有临床应用的希望。有限的临床经验和缺乏前瞻性验证研究仍然是最大的缺点。通过前瞻性、多中心试验进行广泛的测试和验证,开发经过验证和值得信赖的算法,对于未来在甲状腺癌管理的精准医学管道中使用人工智能至关重要。
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Artificial intelligence in the diagnosis of thyroid cancer: Recent advances and future directions
The diagnosis and management of thyroid cancer is fraught with challenges despite the advent of innovative diagnostic, surgical, and chemotherapeutic modalities. Challenges like inaccuracy in prognostication, uncertainty in cytopathological diagnosis, trouble in differentiating follicular neoplasms, intra-observer and inter-observer variability on ultrasound imaging preclude personalised treatment in thyroid cancer. Artificial intelligence (AI) is bringing a paradigm shift to the healthcare, powered by quick advancement of the analytic techniques. Several recent studies have shown remarkable progress in thyroid cancer diagnostics based on AI-assisted algorithms. Application of AI techniques in thyroid ultrasonography and cytopathology have shown remarkable impro-vement in sensitivity and specificity over the traditional diagnostic modalities. AI has also been explored in the development of treatment algorithms for indeterminate nodules and for prognostication in the patients with thyroid cancer. The benefits of high repeatability and straightforward implementation of AI in the management of thyroid cancer suggest that it holds promise for clinical application. Limited clinical experience and lack of prospective validation studies remain the biggest drawbacks. Developing verified and trustworthy algorithms after extensive testing and validation using prospective, multi-centre trials is crucial for the future use of AI in the pipeline of precision medicine in the management of thyroid cancer.
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