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Klinisk anvendelse av AI-assistert ultralydteknologi i den preoperative evalueringen av kreft i skjoldbruskkjertelen

5. august 2026 oppdatert av: Bo Wang,MD, Fujian Medical University
Denne studien tar sikte på å utforske bruken av AI-assistert ultralydteknologi i preoperativ vurdering av kreft i skjoldbruskkjertelen. Tradisjonelle ultralydundersøkelsesdata fra skjoldbruskkjertelkreftpasienter vil bli samlet inn, og AI-systemer vil bli brukt til å oppdage og diagnostisere skjoldbruskknuter og lymfeknuter. I tilfeller der det er uenighet mellom resultatene av todimensjonal ultralyd og AI-system, vil ytterligere bekreftelse bli søkt gjennom biopsi. Deretter vil patologiske resultater tjene som "gullstandarden" for sammenligning mellom AI-systemet og tradisjonelle ultralydundersøkelsesresultater, og vurdere deres nøyaktighet og pålitelighet. Gjennom dette forskningsarbeidet etterstrebes en mer nøyaktig og pålitelig metode for preoperativ vurdering av kreft i skjoldbruskkjertelen, og støtter dermed klinisk beslutningstaking og baner vei for nye anvendelser av AI innen medisinsk bildediagnostikk.

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

Denne studien tar sikte på å undersøke bruken av AI-assistert ultralydteknologi i preoperativ vurdering av kreft i skjoldbruskkjertelen. Tradisjonelle ultralydundersøkelsesdata fra pasienter med kreft i skjoldbruskkjertelen, inkludert todimensjonale ultralydbilder, fargedopplerflytbilder og detaljerte karakteristikker av skjoldbruskknuter og lymfeknuter som antall, størrelse, morfologi, ekkogenisitet, marginer, forkalkninger og sideforhold, vil bli samlet inn. Før operasjonen vil det bli gjennomført en revurdering ved bruk av AI-assistert ultralydteknologi, og deteksjon og diagnostiske resultater av skjoldbruskknuter og lymfeknuter av AI-systemet vil bli registrert. I tilfeller hvor det er uoverensstemmelse mellom resultatene av todimensjonal ultralyd og AI-systemet, vil det bli utført finnålsaspirasjonsbiopsi eller intraoperativ biopsi for ytterligere bekreftelse av deres natur. Etter operasjonen vil de patologiske resultatene av hver knute tjene som "gullstandarden" for komparativ analyse mellom AI-systemet og tradisjonelle todimensjonale ultralydundersøkelser. Nøyaktigheten til AI-systemet for å oppdage og lokalisere knuter vil bli analysert, og dets sensitivitet, spesifisitet og nøyaktighet vil bli beregnet for å evaluere dets diagnostiske effektivitet og pålitelighet i den preoperative vurderingen av kreft i skjoldbruskkjertelen. Gjennom denne forskningen skal en mer nøyaktig og pålitelig tilleggsdiagnostisk metode for preoperativ vurdering av kreft i skjoldbruskkjertelen gis for å hjelpe kliniske beslutninger. I tillegg vil nye veier og retninger for anvendelse av AI innen medisinsk bildediagnose bli utforsket.

Studietype

Intervensjonell

Registrering (Faktiske)

515

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Kina
    • Fujian
      • Fuzhou, Fujian, Kina, 350001
        • Fujian Medical University Union Hospital

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Barn
  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Beskrivelse

Inklusjonskriterier:

  • Pasienter med preoperativ patologisk bekreftelse av maligne svulster i skjoldbruskkjertelen som gjennomgår kirurgisk behandling.
  • Pasienter med godartede svulster i skjoldbruskkjertelen, slik som skjoldbruskkjerteladenomer som forårsaker trykksymptomer, som gjennomgår kirurgisk behandling.
  • Pasienter med komplette og høykvalitets tradisjonelle todimensjonale fargeultralydbilder.
  • Komplette postoperative patologirapporter.
  • Vilje til å delta i denne kliniske studien og signering av informert samtykke.

Ekskluderingskriterier:

  • Pasienter med en historie med nakkekirurgi eller strålebehandling.
  • Pasienter med en historie med ondartede svulster i andre deler av kroppen.
  • Pasienter med skjoldbrusk dysfunksjon.
  • Tradisjonelle todimensjonale ultralydbilder i farger med ufullstendig eller dårlig kvalitet.
  • Ufullstendige postoperative patologirapporter.
  • Avslag på å delta i denne kliniske studien.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Diagnostisk
  • Tildeling: N/A
  • Intervensjonsmodell: Enkeltgruppeoppdrag
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: AI-Assisted Preoperative Review
Participants undergo standard preoperative thyroid ultrasonography followed by a standardized AI-assisted repeat examination and surgeon-led review incorporating the locked AI system's thyroid-nodule output. The AI system does not assess cervical lymph nodes. All supplementary examinations and final diagnostic and surgical decisions are made by clinicians.
Diagnostisk test: Locked AI-Assisted Thyroid Ultrasound Repeat Examination and Review
After standard preoperative ultrasonography, the same participant underwent a standardized AI-assisted repeat examination. The locked system identified and classified thyroid nodules and provided malignancy-score information for surgeon-led review. It did not assess cervical lymph nodes and was not retrained or recalibrated during the study. Additional fine-needle aspiration, intraoperative pathologic examination, and surgical management were determined by clinicians using the complete clinical assessment.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Proportion of Participants Undergoing Supplementary Cytologic or Pathologic Examination
Tidsramme: From completion of the AI-assisted repeat examination through completion of surgery
Number and proportion of enrolled participants who underwent at least one additional cytologic or pathologic examination, such as fine-needle aspiration or intraoperative frozen-section examination, after completion of conventional ultrasonography and AI-assisted review and before completion of surgery. Each participant is counted once regardless of the number of examinations. The decision remained clinician led; cervical lymph-node examinations were outside the AI system's task.
From completion of the AI-assisted repeat examination through completion of surgery
Proportion of Participants With a Change in Planned Surgical Management
Tidsramme: From completion of the AI-assisted review through surgery
Number and proportion of enrolled participants with at least one documented change in the surgeon-led planned surgical approach or extent after conventional ultrasonography, AI-assisted review, and any supplementary pathological examination, when performed. Changes may involve thyroid resection or cervical lymph-node management. Each participant is counted once regardless of the number of changes. The AI system provided thyroid-nodule information only and did not assess cervical lymph nodes.
From completion of the AI-assisted review through surgery

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Distribution of C-TIRADS Categories Among Evaluated Thyroid Nodules
Tidsramme: During standard preoperative ultrasonography, before the AI-assisted repeat examination
Number and percentage of evaluated thyroid nodules in each clinician-assigned C-TIRADS category during conventional ultrasonography. Nodule size, composition, echogenicity, margins, calcifications, and clinician-assessed cervical lymph-node findings were recorded as descriptive covariates and were not treated as separate outcome measures.
During standard preoperative ultrasonography, before the AI-assisted repeat examination
Proportion of Evaluated Thyroid Nodules Classified as AI-Positive
Tidsramme: During the preoperative AI-assisted repeat examination, before surgery
Number and percentage of evaluated thyroid nodules with a locked AI malignancy score >0.5. The AI system evaluated thyroid nodules only and did not assess cervical lymph nodes.
During the preoperative AI-assisted repeat examination, before surgery
Results of Supplementary Cytologic or Pathologic Examinations
Tidsramme: From supplementary sampling to availability of the corresponding result, before or during surgery
Among participants who underwent at least one additional cytologic or pathologic examination, record the cytologic or histopathologic result for each sampled thyroid nodule or cervical lymph node. Results are summarized at the examination level as nonmalignant, indeterminate, malignant, or metastatic, as applicable.
From supplementary sampling to availability of the corresponding result, before or during surgery
Final Histopathological Diagnosis of Resected Thyroid Nodules
Tidsramme: From surgery until the final postoperative histopathology report became available; assessed through October 15, 2025, over the approximately 14-month study period.
For each resected thyroid nodule linked unambiguously to the evaluated lesion, record the final diagnosis as benign, malignant, follicular tumor of uncertain malignant potential (FT-UMP), well-differentiated tumor of uncertain malignant potential (WDT-UMP), non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP), or another borderline diagnosis.
From surgery until the final postoperative histopathology report became available; assessed through October 15, 2025, over the approximately 14-month study period.
Nodule-Level Sensitivity of AI and C-TIRADS
Tidsramme: From the preoperative examinations until the final postoperative histopathology report became available; assessed through October 15, 2025, over the approximately 14-month study period.
Using definitive postoperative histopathology as the reference standard, sensitivity is TP/(TP + FN), expressed as a percentage, for the locked AI classification (positive if score >0.5) and conventional C-TIRADS (positive if category 4a or higher). Include only pathology-matched nodules with an unambiguous lesion-level link and a definitive benign or malignant diagnosis. Exclude FT-UMP, WDT-UMP, NIFTP, other borderline diagnoses, and nodules without unambiguous lesion-level linkage. These lesion-level exclusions do not alter the 515-participant workflow cohort.
From the preoperative examinations until the final postoperative histopathology report became available; assessed through October 15, 2025, over the approximately 14-month study period.
Nodule-Level False-Negative Rate of AI and C-TIRADS
Tidsramme: From the preoperative examinations until the final postoperative histopathology report became available; assessed through October 15, 2025, over the approximately 14-month study period.
For each method, the false-negative rate is FN/(TP + FN), expressed as a percentage, among definitively malignant thyroid nodules. AI positivity is defined as score >0.5; conventional ultrasound positivity is C-TIRADS category 4a or higher. Include only pathology-matched nodules with an unambiguous lesion-level link and a definitive benign or malignant diagnosis. Exclude FT-UMP, WDT-UMP, NIFTP, other borderline diagnoses, and nodules without unambiguous lesion-level linkage.
From the preoperative examinations until the final postoperative histopathology report became available; assessed through October 15, 2025, over the approximately 14-month study period.
Nodule-Level Positive Predictive Value of AI and C-TIRADS
Tidsramme: From the preoperative examinations until the final postoperative histopathology report became available; assessed through October 15, 2025, over the approximately 14-month study period.
For each method, positive predictive value is TP/(TP + FP), expressed as a percentage, among thyroid nodules classified as positive. AI positivity is defined as score >0.5; conventional ultrasound positivity is C-TIRADS category 4a or higher. Include only pathology-matched nodules with an unambiguous lesion-level link and a definitive benign or malignant diagnosis. Exclude FT-UMP, WDT-UMP, NIFTP, other borderline diagnoses, and nodules without unambiguous lesion-level linkage.
From the preoperative examinations until the final postoperative histopathology report became available; assessed through October 15, 2025, over the approximately 14-month study period.
Nodule-Level Youden Index of AI and C-TIRADS
Tidsramme: From the preoperative examinations until the final postoperative histopathology report became available; assessed through October 15, 2025, over the approximately 14-month study period.
For each method, the Youden index is sensitivity + specificity - 1 using fixed binary thresholds. AI positivity is defined as score >0.5; conventional ultrasound positivity is C-TIRADS category 4a or higher. Include only pathology-matched nodules with an unambiguous lesion-level link and a definitive benign or malignant diagnosis. Exclude FT-UMP, WDT-UMP, NIFTP, other borderline diagnoses, and nodules without unambiguous lesion-level linkage.
From the preoperative examinations until the final postoperative histopathology report became available; assessed through October 15, 2025, over the approximately 14-month study period.
Distribution of Cervical Lymph-Node Metastasis Status Among Pathologically Examined Nodes
Tidsramme: From surgery or supplementary sampling until the corresponding pathology result became available; assessed through October 15, 2025, over the approximately 14-month study period.
Among cervical lymph nodes actually removed or sampled and pathologically examined, record the number and percentage with and without metastasis. No pathologic reference diagnosis is assigned to unsampled lymph nodes.
From surgery or supplementary sampling until the corresponding pathology result became available; assessed through October 15, 2025, over the approximately 14-month study period.
Nodule-Level Specificity of AI and C-TIRADS
Tidsramme: From the preoperative examinations until the final postoperative histopathology report became available; assessed through October 15, 2025, over the approximately 14-month study period.
Using definitive postoperative histopathology as the reference standard, specificity is TN/(TN + FP), expressed as a percentage, for the locked AI classification (positive if score >0.5) and conventional C-TIRADS (positive if category 4a or higher). Include only pathology-matched nodules with an unambiguous lesion-level link and a definitive benign or malignant diagnosis. Exclude FT-UMP, WDT-UMP, NIFTP, other borderline diagnoses, and nodules without unambiguous lesion-level linkage.
From the preoperative examinations until the final postoperative histopathology report became available; assessed through October 15, 2025, over the approximately 14-month study period.
Nodule-Level Negative Predictive Value of AI and C-TIRADS
Tidsramme: From the preoperative examinations until the final postoperative histopathology report became available; assessed through October 15, 2025, over the approximately 14-month study period.
Using definitive postoperative histopathology as the reference standard, negative predictive value is TN/(TN + FN), expressed as a percentage, for the locked AI classification (positive if score >0.5) and conventional C-TIRADS (positive if category 4a or higher). Include only pathology-matched nodules with an unambiguous lesion-level link and a definitive benign or malignant diagnosis. Exclude FT-UMP, WDT-UMP, NIFTP, other borderline diagnoses, and nodules without unambiguous lesion-level linkage.
From the preoperative examinations until the final postoperative histopathology report became available; assessed through October 15, 2025, over the approximately 14-month study period.
Nodule-Level Accuracy of AI and C-TIRADS
Tidsramme: From the preoperative examinations until the final postoperative histopathology report became available; assessed through October 15, 2025, over the approximately 14-month study period.
Using definitive postoperative histopathology as the reference standard, accuracy is (TP + TN)/(TP + TN + FP + FN), expressed as a percentage, for the locked AI classification (positive if score >0.5) and conventional C-TIRADS (positive if category 4a or higher). Include only pathology-matched nodules with an unambiguous lesion-level link and a definitive benign or malignant diagnosis. Exclude FT-UMP, WDT-UMP, NIFTP, other borderline diagnoses, and nodules without unambiguous lesion-level linkage.
From the preoperative examinations until the final postoperative histopathology report became available; assessed through October 15, 2025, over the approximately 14-month study period.
Area Under the ROC Curve for the Continuous AI Malignancy Score
Tidsramme: From the preoperative examinations until the final postoperative histopathology report became available; assessed through October 15, 2025, over the approximately 14-month study period.
Using definitive postoperative histopathology as the reference standard, calculate the area under the receiver operating characteristic curve for the continuous locked AI malignancy score. Include only pathology-matched nodules with an unambiguous lesion-level link and a definitive benign or malignant diagnosis. Exclude FT-UMP, WDT-UMP, NIFTP, other borderline diagnoses, and nodules without unambiguous lesion-level linkage. No AUC is calculated for the single-threshold C-TIRADS classification.
From the preoperative examinations until the final postoperative histopathology report became available; assessed through October 15, 2025, over the approximately 14-month study period.

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Fujian Medical University

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

1. september 2024

Primær fullføring (Faktiske)

28. september 2025

Studiet fullført (Faktiske)

15. oktober 2025

Datoer for studieregistrering

Først innsendt

9. juni 2024

Først innsendt som oppfylte QC-kriteriene

11. juli 2024

Først lagt ut (Faktiske)

12. juli 2024

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

7. august 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

5. august 2026

Sist bekreftet

1. august 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • AI-base PCD

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

IPD-planbeskrivelse

Individual participant data are not planned for external sharing because the dataset contains detailed clinical records and ultrasound images that may remain re-identifiable, and the available study records do not document participant consent specifically permitting external IPD sharing or institutional authorization for such sharing. Aggregate, non-identifiable results will be reported in publications.

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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