scholarly journals Machine learning methods for automated classification of tumors with papillary thyroid carcinoma-like nuclei: A quantitative analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257635
Author(s):  
Moritz Böhland ◽  
Lars Tharun ◽  
Tim Scherr ◽  
Ralf Mikut ◽  
Veit Hagenmeyer ◽  
...  

When approaching thyroid gland tumor classification, the differentiation between samples with and without “papillary thyroid carcinoma-like” nuclei is a daunting task with high inter-observer variability among pathologists. Thus, there is increasing interest in the use of machine learning approaches to provide pathologists real-time decision support. In this paper, we optimize and quantitatively compare two automated machine learning methods for thyroid gland tumor classification on two datasets to assist pathologists in decision-making regarding these methods and their parameters. The first method is a feature-based classification originating from common image processing and consists of cell nucleus segmentation, feature extraction, and subsequent thyroid gland tumor classification utilizing different classifiers. The second method is a deep learning-based classification which directly classifies the input images with a convolutional neural network without the need for cell nucleus segmentation. On the Tharun and Thompson dataset, the feature-based classification achieves an accuracy of 89.7% (Cohen’s Kappa 0.79), compared to the deep learning-based classification of 89.1% (Cohen’s Kappa 0.78). On the Nikiforov dataset, the feature-based classification achieves an accuracy of 83.5% (Cohen’s Kappa 0.46) compared to the deep learning-based classification 77.4% (Cohen’s Kappa 0.35). Thus, both automated thyroid tumor classification methods can reach the classification level of an expert pathologist. To our knowledge, this is the first study comparing feature-based and deep learning-based classification regarding their ability to classify samples with and without papillary thyroid carcinoma-like nuclei on two large-scale datasets.

2021 ◽  
pp. 1-11
Author(s):  
Yaning Liu ◽  
Lin Han ◽  
Hexiang Wang ◽  
Bo Yin

Papillary thyroid carcinoma (PTC) is a common carcinoma in thyroid. As many benign thyroid nodules have the papillary structure which could easily be confused with PTC in morphology. Thus, pathologists have to take a lot of time on differential diagnosis of PTC besides personal diagnostic experience and there is no doubt that it is subjective and difficult to obtain consistency among observers. To address this issue, we applied deep learning to the differential diagnosis of PTC and proposed a histological image classification method for PTC based on the Inception Residual convolutional neural network (IRCNN) and support vector machine (SVM). First, in order to expand the dataset and solve the problem of histological image color inconsistency, a pre-processing module was constructed that included color transfer and mirror transform. Then, to alleviate overfitting of the deep learning model, we optimized the convolution neural network by combining Inception Network and Residual Network to extract image features. Finally, the SVM was trained via image features extracted by IRCNN to perform the classification task. Experimental results show effectiveness of the proposed method in the classification of PTC histological images.


Author(s):  
Stamatina Ioakim ◽  
Vasilis Constantinides ◽  
Meropi Toumba ◽  
Theodoros Lyssiotis ◽  
Angelos Kyriacou

Summary Our objective is to demonstrate the importance of considering microcalcifications even without evidence of nodules as a potential sign of malignancy. Current guidelines, such as those of the British Thyroid Association, acknowledge the clinical significance of microcalcifications only when found within nodules. In this case, they are considered a suspicious feature, classifying the nodules as U5 (i.e. high risk) where fine-needle aspiration biopsy (FNAB) is warranted, following the high likelihood of cancer in these nodules. In addition, there is a dearth of evidence of ultrasound scan (USS) detection of microcalcifications in the thyroid gland outside of nodules, along with their associated clinical implications. Yet, this clinical manifestation is not so infrequent considering that we do encounter patients in the clinic showing these findings upon ultrasound examination. Three patients who presented to our clinic with thyroid-related symptoms were shown to have areas of microcalcifications without a nodule upon sonographic evaluation of their thyroid gland. These incidentally detected hyperechoic foci were later confirmed to correspond to areas of papillary thyroid carcinoma (PTC) on histopathological examination of resected tissue following thyroidectomy. Four more cases were identified with sonographic evidence of microcalcifications without nodules and given their clinical and other sonographic characteristics were managed with active surveillance instead. Learning points Echogenic foci known as microcalcifications may be visible without apparent association to nodular structures. Microcalcifications without nodules may not be an infrequent finding. Microcalcifications are frequently indicative of malignancy within the thyroid gland even without a clearly delineated nodule. Empirically, the usual guidelines for the management of thyroid nodules can be applied to the management of microcalcifications not confined to a nodule, but such a finding per se should be classified as a ‘high-risk’ sign.


2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Sun Hye Jeong ◽  
Hyun Sook Hong ◽  
Eun Hye Lee ◽  
Jeong Ja Kwak

Objectives. We compared the ultrasonography and pathology features of papillary thyroid carcinoma (PTC) in pediatric and adolescents with Hashimoto’s thyroiditis (HT) with those of non-HT patients.Materials and Methods. Eleven patients who were surgically confirmed to have pediatric or adolescent PTC from 2006 to 2014 were included in this study. We retrospectively analyzed the preoperative ultrasonography and pathology features of PTC arising in HT and non-HT patients.Results. On ultrasonography, thyroid gland was lobulated and enlarged, with many scattered microcalcifications in four of five HT patients. Four of six non-HT patients had suspicious masses with calcifications. The diffuse sclerosing variant of PTC (DSVPTC) was found in three of five HT patients, but none in non-HT patients. Macroscopic or microscopic extrathyroidal extension was evident in all of the HT patients and four of the non-HT patients. Neck lymph node metastases were in all HT patients and five of non-HT patients.Conclusions. Three of five PTCs in pediatric and adolescent HT patients were DSVPTC, whereas all PTCs of the non-HT patients were classic type. On ultrasonography, thyroid gland was diffusely enlarged with scattered microcalcifications in four of five HT patients. All five HT cases had aggressive disease, including extrathyroidal extension and cervical lymph node metastases.


2019 ◽  
Vol 101 (5) ◽  
pp. e122-e124
Author(s):  
O Hamdy ◽  
S Raafat ◽  
GA Saleh ◽  
K Atallah ◽  
Mahmoud M Saleh ◽  
...  

Primary thyroid carcinoma after thyroid ablation by radioactive iodine is rare. We present a very rare condition of lateral apparent papillary thyroid carcinoma eight years after receiving radioactive iodine for thyrotoxicosis, which led to complete anatomical and functional involution of the thyroid gland.


2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Panagiotis Paliogiannis ◽  
Federico Attene ◽  
Federica Trogu ◽  
Mario Trignano

We present a case of Warthin-like papillary thyroid carcinoma in a 22-year-old woman and a review of the literature on the topic. The patient had the occasional discovery of a hypoechoic thyroid nodule of approximately 18 mm, characterized by irregular margins, hyperechoic spots, rich intra- and perilesional vascularization, and a suspicious enlarged right laterocervical lymph node. Fine-needle aspiration was performed for both lesions and the diagnosis of papillary thyroid carcinoma without lymph node involvement was made. The patient underwent thyroidectomy and central neck lymphadenectomy without complications. Histopathological examination suggested a Warthin-like papillary carcinoma of the thyroid gland, with all the removed lymph nodes being free of disease. The patient subsequently underwent iodine ablative therapy and she remains free of disease one year after surgery. Warthin-like papillary thyroid carcinoma is a recently described variant of papillary thyroid cancer that is frequently associated with lymphocytic thyroiditis. Morphologically, it resembles Warthin tumors of the salivary glands, with T and B lymphocytes infiltrating the stalks of papillae lined with oncocytic cells. Surgical and postoperative management is identical to that of classic differentiated thyroid cancer, while prognosis seems to be favourable.


2013 ◽  
Vol 127 (7) ◽  
pp. 724-727 ◽  
Author(s):  
J J Xu ◽  
K Kwan ◽  
K Fung

AbstractObjective:To review the diagnosis of primary papillary carcinoma of ectopic thyroid tissue within branchial cleft cysts, and to discuss the diagnostic challenge of differentiating this condition from metastatic disease when an occult microcarcinoma is found in the thyroid gland.Methods:These comprise a case report and a literature review. We present the case of a 75-year-old woman with papillary thyroid carcinoma within the wall of a recurrent, 15 cm, lateral neck cyst.Results:Histological examination of the patient's thyroid gland found a 0.5 mm papillary thyroid microcarcinoma.Conclusion:Our differential diagnosis was primary papillary carcinoma arising from ectopic thyroid tissue, or metastatic cystic degeneration of a lateral lymph node. We make an argument for the former.


2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Katty Manrique Franco ◽  
Helard Andres Manrique ◽  
William Lapa Yauri ◽  
José Solis Villanueva

Abstract BACKGROUND In the thyroglossal duct (TD) there are remains of thyroid tissue in 1-40%. Thyroid cancer diagnosed in this duct is an uncommon finding, with a prevalence of less 1% and must meet these criteria: identify the TD, locate remains of carcinoma in it; absence of cancer in the thyroid gland and presence of thyroid follicles in the TD. We present a patient with thyroid cancer in the TD. CLINICAL CASE 63-years-old-woman. 18 months ago, she noted a submandibular tumor associated to asthenia, weight loss and tremor. On physical examination: 3cm tumor, increased consistency, near to the hyoid bone and 1.5cm left cervical adenopathy. Blood analysis: TSH 0.01 (0.2-4.5) and FT4 5.53 (0.9-1.7). Hyperthyroidism was diagnosed and she started Tiamazol 10mg/bid and propanolol 20mg/tid. Thyroid US: diffuse goiter. Soft tissue US: heterogeneous mass 39x15x26mm in midline of suprathyroid region suggestive of neoformative process. Cervical CT scan: solid, heterogeneous, neoformative tissue, located in the midline, infiltrating prelaringeal muscles in contact with hyoid bone. Cervical adenopathy in group II on right side and group III and IV on the left side. Increase in thyroid gland volume. FNA US guided of suprathyroid tumor was performed: cytology compatible with papillary thyroid carcinoma, Bethesda VI. FNA left adenopathy: compatible with metastasis papillary carcinoma. Midline tumor exeresis in relation to a TD (Sistrunk surgery), total thyroidectomy plus left lymph node dissection group IIA, IIB, III, IV and V was performed. Surgical findings: Right lobe thyroid 4x3x2cm with 1cm nodule on the upper pole. Left thyroid lobe 6x4x2cm with multiple nodules, the largest one in upper pole, 2cm. Multiple adenopathies. A 3x3x1cm tumor with irregular edges, hard consistency, adhered to the hyoid bone was removed. The histology was compatible with papillary thyroid carcinoma in the TD. Thyroid gland was informed as simple goiter. 150ug of levothyroxine was initiated. Six months later, she receives 100mCi I131. The total body scan was positive for thyroid remnant in cervical region. TSH 0.8 FT4 1.71. Thyroglobulin (TG) 13.98 and AntiTG 400. One year later, new total body scan was negative. TG 10,3 and antiTG 816. New thyroid US showed group III cervical adenopathy 4x7x3mm. Biopsy was compatible with metastasis of papillary thyroid carcinoma. The patient is awaiting a new surgery for lymph node dissection. CONCLUSION Sistrunk surgery and total thyroidectomy plus lymphadenectomy should be the treatment of choice in thyroid cancer in TD, followed by ablative therapy. This attitude improves long-term follow-up and reduces the risk of recurrence. BIBLIOGRAPHY 1. Granado A, et al. Cáncer del conducto tirogloso. Acta Chir Catal, 8 (1987), 37-44 2. Echenique E. Thyroid cancer arising in a thyroglossal duct cyst. Cir Esp. 2000 67 (6) 567-71.


2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Reza Pishdad ◽  
Regine Boutin ◽  
Richard Hajjar ◽  
Mohammed Jaloudi ◽  
Mark Galan ◽  
...  

Abstract A Coexisting of Two Different Thyroid Malignancies: A Collision Phenomenon Introduction: Collision tumors are rare clinical entities wherein two histologically distinct tumor types occur at the same anatomic sites. Simultaneous papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC) of the same thyroid is a very rare occurrence with limited clinical information. Herein, we report a case of PTC and FTC of the same thyroid lobe. Clinical case: A 79-year-old man presented to the emergency department for evaluation of left hip pain of 2-month duration. Three days before presentation, he sustained a physical trauma to the left side of his body. X-ray imaging of the left femur revealed a lytic bony lesion measuring approximately 5.2 cm x 4.2 cm at the proximal end of left femur as well as a displaced pathologic fracture of its lesser trochanter. Biopsies of the bone lytic lesion suggested metastatic follicular thyroid carcinoma. CT of the neck revealed an enlarged thyroid with a cystic lesion as well as 2 nodules in the left lobe of thyroid gland. Total thyroidectomy was performed. Histopathology revealed 2 separate primary malignancies of PTC and FTC. Following diagnosis, laboratory test results showed TSH 2.6 uIU/mL (reference range, 0.2–4), anti-thyroglobulin antibody (anti Tg) < 1.0 IU/mL (reference range, 0.0–0.9), calcitonin 8.4 pg/mL (reference range, 0–8.4), and CEA 1.1 ng/mL (reference range, 0.0–3.0). The patient was placed on thyroid hormone replacement therapy and was treated with external beam radiation to his bone metastasis. He was scheduled for later further thyroid ablation. In his follow-up visit, three months later, he reported no pain on ambulation. Discussion: For each type of thyroid malignancy, several genes have been identified. However, to date, no common gene mutation responsible for the pathogenesis of the different tumor types has been determined. For instance, point mutations of the RAS oncogene are found in about 40% of thyroid neoplasms (N-RAS, H-RAS, and K-RAS, in order of decreasing frequency) including both PTC and FTC. No single theory can completely explain the pathogenesis of these tumors in all cases, and so, with the present level of understanding of the disease, a combination of theories must be accepted. Management of collision tumors of the thyroid gland is usually complex owing to the presence of dual pathology in the tumor tissues and given the fact that literature on this condition is scarce. Generally, the treatment needs to be individualized. Conclusion: Most likely, a rare phenomenon of simultaneous mutation of different genes can give birth to contemporary different thyroidal neoplasms. References: Zhu Z, Gandhi M, Nikiforova MN, et al. Molecular profile and clinical-pathologic features of the follicular variant of papillary thyroid carcinoma. An unusually high prevalence of ras mutations. Am J Clin Pathol 2003; 120:71.


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