Thyroid gland delineation in noncontrast-enhanced CTs using deep convolutional neural networks

The purpose of this study is to develop a deep learning method for thyroid delineation with high accuracy, efficiency, and robustness in noncontrast-enhanced head and neck CTs. The cross-sectional analysis consisted of six tests, including randomized cross-validation and hold-out experiments, tests of prediction accuracy between cancer and benign and cross-gender analysis were performed to evaluate the proposed deep-learning-based performance method. CT images of 1977 patients with suspected thyroid carcinoma were retrospectively investigated. The automatically segmented thyroid gland volume was compared against physician-approved clinical contours using metrics, the Pearson correlation and Bland-Altman analysis. Quantitative metrics included: the Dice similarity coefficient (DSC), sensitivity, specificity, Jaccard index (JAC), Hausdorff distance (HD), mean surface distance (MSD), residual mean square distance (RMSD) and the center of mass distance (CMD). The robustness of the proposed method was further tested using the nonparametric Kruskal-Wallis test to assess the equality of distribution of DSC values. The proposed method's accuracy remained high through all the tests, with the median DSC, JAC, sensitivity and specificity higher than 0.913, 0.839, 0.856 and 0.979, respectively. The proposed method also resulted in median MSD, RMSD, HD and CMD, of less than 0.31 mm, 0.48 mm, 2.06 mm and 0.50 mm, respectively. The MSD and RMSD were 0.40 ± 0.29 mm and 0.70 ± 0.46 mm, respectively. Concurrent testing of the proposed method with 3D U-Net and V-Net showed that the proposed method had significantly improved performance. The proposed deep-learning method achieved accurate and robust performance through six cross-sectional analysis tests.