Abstract

Simple SummaryDifferentiated thyroid cancer (DTC) is the most common endocrine malignancy with a high incidence rate in females. The COVID-19 epidemic posed an increased risk of treatment delay causing increased DTC morbidity and mortality rate of DTC. Several imaging techniques, including ultrasound (US), magnetic resonance imaging (MRI), and computer tomography (CT), have been applied in the early screening and diagnosis of DTC. However, these traditional methods have limited sensitivity and specificity due to dependence on the experience and skill of the radiologists.Radiomics is an emerging technique that allows the quantitative extraction of high-throughput features from single or multiple medical images, which cannot be observed directly with the naked eye, and then applies to machine learning approaches to construct classification or prediction models. This method makes it possible to evaluate tumor status and to differentiate malignant from benign tumors or nodules in a more objective manner. To date, the classification and prediction value of radiomics in DTC patients have been inconsistent. Herein, we summarize the available literature on the classification and prediction performance of radiomics-based DTC in various imaging techniques. More specifically, we reviewed the recent literature to discuss the capacity of radiomics to predict lymph node (LN) metastasis, distant metastasis, tumor extrathyroidal extension, disease-free survival, and B-Raf proto-oncogene serine/threonine kinase (BRAF) mutation and differentiate malignant from benign nodules. This review discusses the application and limitations of the radiomics process, and explores its ability to improve clinical decision-making with the hope of emphasizing its utility for DTC patients.

Highlights

  • A recent study confirmed that the recurrence rate of well-differentiated thyroid cancer (DTC) is higher in men compared with women

  • While previous original studies consistently negated the value of US radiomics in predicting B-Raf proto-oncogene serine/threonine kinase (BRAF) mutations in DTC

  • This result may need to be thoroughly discussed to determine the predictive value of other imaging techniques, such as computed tomography (CT) and magnetic resonance imaging (MRI), and provide a direct or indirect relationship between radiomics and tumor mutations of thyroid cancer in the future study

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Summary

The Epidemiology and Pathophysiology of Thyroid Cancer

Thyroid cancer is the most common endocrine malignancy and the most commonly diagnosed cancer in people aged 15 to 29 years, and its incidence has continuously increased with 567,233 cases and approximately 41,000 deaths worldwide in 2018 [1,2]. A recent study confirmed that the recurrence rate of well-differentiated thyroid cancer (DTC) is higher in men compared with women. Well DTC is a composite of papillary thyroid cancer (PTC), follicular thyroid cancer (FTC), and Hurthle cell thyroid cancer. Papillary thyroid cancer is the most common thyroid cancer with the best prognosis, whereas follicular, Hurthle cell, poorly-differentiated, and C-cell derived thyroid cancers are relatively uncommon but have a high metastatic risk to the lung and bone [7]. Despite the generally stable course, favorable prognosis, and low mortality of thyroid cancer, the rate of local recurrence and distant metastases of DTC approaches 10% to 30%, which depends on the length of follow-up [10,11].

Imaging Techniques for DTC Detection
The Definition of Radiomics
Radiomic Features
The Workflow of Radiomics
Clinical Applications of Radiomics
Literature Search
Radiomics in Thyroid Cancer Prediction
Method manual
Radiomics in Thyroid Cancer and Nodule Classification
Limitations
Findings
Conclusions
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