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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 張金堅(KING-JEN CHANG),陳正剛(ARGON CHEN) | |
dc.contributor.author | KUEN-YUAN CHEN | en |
dc.contributor.author | 陳坤源 | zh_TW |
dc.date.accessioned | 2021-06-16T05:21:18Z | - |
dc.date.available | 2014-10-15 | |
dc.date.copyright | 2014-10-15 | |
dc.date.issued | 2014 | |
dc.date.submitted | 2014-08-15 | |
dc.identifier.citation | Ahuja A, Chick W, King W, Metreweli C. Clinical significance of the comet-tail artifact in thyroid ultrasound. Journal of clinical ultrasound : JCU 1996;24:129-33.
Alexander EK, Heering JP, Benson CB, Frates MC, Doubilet PM, Cibas ES, Marqusee E. Assessment of nondiagnostic ultrasound-guided fine needle aspirations of thyroid nodules. The Journal of clinical endocrinology and metabolism 2002;87:4924-7. Alexander EK, Hurwitz S, Heering JP, Benson CB, Frates MC, Doubilet PM, Cibas ES, Larsen PR, Marqusee E. Natural history of benign solid and cystic thyroid nodules. Annals of internal medicine 2003;138:315-8. Alexander EK, Marqusee E, Orcutt J, Benson CB, Frates MC, Doubilet PM, Cibas ES, Atri A. Thyroid nodule shape and prediction of malignancy. Thyroid : official journal of the American Thyroid Association 2004;14:953-8. Andreotti RF, Fleischer AC. The sonographic diagnosis of adenomyosis. Ultrasound quarterly 2005;21:167-70. Bellantone R, Lombardi CP, Raffaelli M, Traini E, De Crea C, Rossi ED, Fadda G. Management of cystic or predominantly cystic thyroid nodules: the role of ultrasound-guided fine-needle aspiration biopsy. Thyroid : official journal of the American Thyroid Association 2004;14:43-7. Brander A, Viikinkoski P, Nickels J, Kivisaari L. Thyroid gland: US screening in a random adult population. Radiology 1991;181:683-7. Bruneton JN, Balu-Maestro C, Marcy PY, Melia P, Mourou MY. Very high frequency (13 MHz) ultrasonographic examination of the normal neck: detection of normal lymph nodes and thyroid nodules. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine 1994;13:87-90. Chan BK, Desser TS, McDougall IR, Weigel RJ, Jeffrey RB, Jr. Common and uncommon sonographic features of papillary thyroid carcinoma. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine 2003;22:1083-90. Chen KY, Chen CN, Wu MH, Ho MC, Tai HC, Huang WC, Chung YC, Chen A, Chang KJ. Computerized detection and quantification of microcalcifications in thyroid nodules. Ultrasound in medicine & biology 2011;37:870-8. Chow LS, Gharib H, Goellner JR, van Heerden JA. Nondiagnostic thyroid fine-needle aspiration cytology: management dilemmas. Thyroid : official journal of the American Thyroid Association 2001;11:1147-51. Cibas ES, Ali SZ, Conference NCITFSotS. The Bethesda System For Reporting Thyroid Cytopathology. American journal of clinical pathology 2009;132:658-65. Court-Payen M, Nygaard B, Horn T, Krag Jacobsen G, Braendstrup O, Narvestad E, Mark Pedersen L, Hancke S, Holm HH. US-guided fine-needle aspiration biopsy of thyroid nodules. Acta radiologica (Stockholm, Sweden : 1987) 2002;43:131-40. Danese D, Sciacchitano S, Farsetti A, Andreoli M, Pontecorvi A. Diagnostic accuracy of conventional versus sonography-guided fine-needle aspiration biopsy of thyroid nodules. Thyroid : official journal of the American Thyroid Association 1998;8:15-21. Davies L, Welch HG. Increasing incidence of thyroid cancer in the United States, 1973-2002. JAMA : the journal of the American Medical Association 2006;295:2164-7. Desser TS, Kamaya A. Ultrasound of thyroid nodules. Neuroimaging clinics of North America 2008;18:463-78, vii. Elisei R, Romei C, Vorontsova T, Cosci B, Veremeychik V, Kuchinskaya E, Basolo F, Demidchik EP, Miccoli P, Pinchera A, Pacini F. RET/PTC rearrangements in thyroid nodules: studies in irradiated and not irradiated, malignant and benign thyroid lesions in children and adults. The Journal of clinical endocrinology and metabolism 2001;86:3211-6. Ellison E, Lapuerta P, Martin SE. Psammoma bodies in fine-needle aspirates of the thyroid: predictive value for papillary carcinoma. Cancer 1998;84:169-75. Fraker DL. Thyroid tumors. In: DeVita V Jr HS, Rosenberg S, eds., ed. Cancer: principles and practice of oncology. Philadelphia, PA: Lippincott-Raven 1997. pp. 1629-52. Frates J, Severoni E. Consumer-directed health plans: enrollee views, early employer experience. Managed care (Langhorne, Pa) 2005;14:58-60, 3--5. Frates MC BC, Doubilet PM, et al. Likelihood of Thyroid Cancer Based on Sonographic Assessment of Nodule Size and Composition[Abstract]. In: ed. In: Radiological Society of North America, Assembly and Annual Meeting Program. Oak Brook, IL: Radiological Society of North America: 2004. pp. 395. Frates MC, Benson CB, Charboneau JW, Cibas ES, Clark OH, Coleman BG, Cronan JJ, Doubilet PM, Evans DB, Goellner JR, Hay ID, Hertzberg BS, Intenzo CM, Jeffrey RB, Langer JE, Larsen PR, Mandel SJ, Middleton WD, Reading CC, Sherman SI, Tessler FN. Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement. Radiology 2005a;237:794-800. Frates MC, Benson CB, Charboneau JW, Cibas ES, Clark OH, Coleman BG, Cronan JJ, Doubilet PM, Evans DB, Goellner JR, Hay ID, Hertzberg BS, Intenzo CM, Jeffrey RB, Langer JE, Larsen PR, Mandel SJ, Middleton WD, Reading CC, Sherman SI, Tessler FN, Society of Radiologists in U. Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement. Radiology 2005b;237:794-800. Frates MC, Benson CB, Doubilet PM, Cibas ES, Marqusee E. Can color Doppler sonography aid in the prediction of malignancy of thyroid nodules? Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine 2003;22:127-31; quiz 32-4. Gharib H, Goellner JR. Fine-needle aspiration biopsy of the thyroid: an appraisal. Annals of internal medicine 1993;118:282-9. Giger ML. Update on the potential of computer-aided diagnosis for breast cancer. Future oncology (London, England) 2010;6:1-4. Gilbert FJ, Astley SM, Gillan MG, Agbaje OF, Wallis MG, James J, Boggis CR, Duffy SW, Group CI. Single reading with computer-aided detection for screening mammography. N Engl J Med 2008;359:1675-84. Gilliland FD, Hunt WC, Morris DM, Key CR. Prognostic factors for thyroid carcinoma. A population-based study of 15,698 cases from the Surveillance, Epidemiology and End Results (SEER) program 1973-1991. Cancer 1997;79:564-73. Grant CS, Hay ID, Gough IR, McCarthy PM, Goellner JR. Long-term follow-up of patients with benign thyroid fine-needle aspiration cytologic diagnoses. Surgery 1989;106:980-5; discussion 5-6. Gruszauskas NP, Drukker K, Giger ML, Chang RF, Sennett CA, Moon WK, Pesce LL. Breast US computer-aided diagnosis system: robustness across urban populations in South Korea and the United States. Radiology 2009;253:661-71. Hadjiiski L, Chan HP, Sahiner B, Helvie MA, Roubidoux MA, Blane C, Paramagul C, Petrick N, Bailey J, Klein K, Foster M, Patterson S, Adler D, Nees A, Shen J. Improvement in radiologists' characterization of malignant and benign breast masses on serial mammograms with computer-aided diagnosis: an ROC study. Radiology 2004;233:255-65. Hagag P, Strauss S, Weiss M. Role of ultrasound-guided fine-needle aspiration biopsy in evaluation of nonpalpable thyroid nodules. Thyroid : official journal of the American Thyroid Association 1998;8:989-95. Han MA, Choi KS, Lee HY, Kim Y, Jun JK, Park EC. Current status of thyroid cancer screening in Korea: results from a nationwide interview survey. Asian Pacific journal of cancer prevention : APJCP 2011;12:1657-63. Hegedus L, Bonnema SJ, Bennedbaek FN. Management of simple nodular goiter: current status and future perspectives. Endocrine reviews 2003;24:102-32. Holden A. The role of colour and duplex Doppler ultrasound in the assessment of thyroid nodules. Australasian radiology 1995;39:343-9. Hughes DT, Haymart MR, Miller BS, Gauger PG, Doherty GM. The most commonly occurring papillary thyroid cancer in the United States is now a microcarcinoma in a patient older than 45 years. Thyroid : official journal of the American Thyroid Association 2011;21:231-6. Hupse R, Samulski M, Lobbes MB, Mann RM, Mus R, den Heeten GJ, Beijerinck D, Pijnappel RM, Boetes C, Karssemeijer N. Computer-aided detection of masses at mammography: interactive decision support versus prompts. Radiology 2013;266:123-9. Iannuccilli JD, Cronan JJ, Monchik JM. Risk for malignancy of thyroid nodules as assessed by sonographic criteria: the need for biopsy. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine 2004;23:1455-64. Inskip PD, Hartshorne MF, Tekkel M, Rahu M, Veidebaum T, Auvinen A, Crooks LA, Littlefield LG, McFee AF, Salomaa S, Makinen S, Tucker JD, Sorensen KJ, Bigbee WL, Boice JD, Jr. Thyroid nodularity and cancer among Chernobyl cleanup workers from Estonia. Radiation research 1997;147:225-35. Iussich G, Correale L, Senore C, Segnan N, Laghi A, Iafrate F, Campanella D, Neri E, Cerri F, Hassan C, Regge D. CT colonography: preliminary assessment of a double-read paradigm that uses computer-aided detection as the first reader. Radiology 2013;268:743-51. Jemal A, Murray T, Ward E, Samuels A, Tiwari RC, Ghafoor A, Feuer EJ, Thun MJ. Cancer statistics, 2005. CA: a cancer journal for clinicians 2005;55:10-30. Jun P, Chow LC, Jeffrey RB. The sonographic features of papillary thyroid carcinomas: pictorial essay. Ultrasound quarterly 2005;21:39-45. Khoo ML, Asa SL, Witterick IJ, Freeman JL. Thyroid calcification and its association with thyroid carcinoma. Head & neck 2002;24:651-5. Kim EK, Park CS, Chung WY, Oh KK, Kim DI, Lee JT, Yoo HS. New sonographic criteria for recommending fine-needle aspiration biopsy of nonpalpable solid nodules of the thyroid. AJR American journal of roentgenology 2002;178:687-91. Kim JY, Lee CH, Kim SY, Jeon WK, Kang JH, An SK, Jun WS. Radiologic and pathologic findings of nonpalpable thyroid carcinomas detected by ultrasonography in a medical screening center. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine 2008;27:215-23. Kunreuther E OJ, Benson CB, et al. Prevalence and distribution of carcinoma in the uninodular and multinodular goiter. 2004. Lee SH, Baek JS, Lee JY, Lim JA, Cho SY, Lee TH, Ku YH, Kim HI, Kim MJ. Predictive factors of malignancy in thyroid nodules with a cytological diagnosis of follicular neoplasm. Endocrine pathology 2013;24:177-83. Loren DE, Seghal CM, Ginsberg GG, Kochman ML. Computer-assisted analysis of lymph nodes detected by EUS in patients with esophageal carcinoma. Gastrointestinal endoscopy 2002;56:742-6. Maitra A AA. .The endocrine system. . In: In: Kumar V AA, Fausto N, eds., ed. Robbins and Cotran's Pathologic Basis of Disease. Philadelphia, PA: Saunders: 1994. pp. 1155-226. McHenry CR, Walfish PG, Rosen IB. Non-diagnostic fine needle aspiration biopsy: a dilemma in management of nodular thyroid disease. The American surgeon 1993;59:415-9. Merino MJ, Middleton LP. Pathology of the thyroid In: Pilch BZ, ed. Head and neck surgical pathology. Philadelphia: Lippincott Williams & Wilkins, 2001. pp. 358-63. Merino MJ ML. Pathology of the thyroid. In: Pilch BZ, ed. In: ed. Head and neck surgical pathology Philadelphia, PA: Lippincott Williams & Wilkins: 2001. pp. 358-63. Moon WJ, Jung SL, Lee JH, Na DG, Baek JH, Lee YH, Kim J, Kim HS, Byun JS, Lee DH. Benign and malignant thyroid nodules: US differentiation--multicenter retrospective study. Radiology 2008a;247:762-70. Moon WJ, Jung SL, Lee JH, Na DG, Baek JH, Lee YH, Kim J, Kim HS, Byun JS, Lee DH, Thyroid Study Group KSoN, Head, Neck R. Benign and malignant thyroid nodules: US differentiation--multicenter retrospective study. Radiology 2008b;247:762-70. Nam-Goong IS, Kim HY, Gong G, Lee HK, Hong SJ, Kim WB, Shong YK. Ultrasonography-guided fine-needle aspiration of thyroid incidentaloma: correlation with pathological findings. Clinical endocrinology 2004;60:21-8. Nikiforova MN, Wald AI, Roy S, Durso MB, Nikiforov YE. Targeted next-generation sequencing panel (ThyroSeq) for detection of mutations in thyroid cancer. The Journal of clinical endocrinology and metabolism 2013;98:E1852-60. Pacella CM, Guglielmi R, Fabbrini R, Bianchini A, Rinaldi R, Panunzi C, Pacella S, Crescenzi A, Papini E. Papillary carcinoma in small hypoechoic thyroid nodules: predictive value of echo color Doppler evaluation. Preliminary results. Journal of experimental & clinical cancer research : CR 1998;17:127-8. Papini E, Guglielmi R, Bianchini A, Crescenzi A, Taccogna S, Nardi F, Panunzi C, Rinaldi R, Toscano V, Pacella CM. Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color-Doppler features. The Journal of clinical endocrinology and metabolism 2002;87:1941-6. Paulinelli RR, Freitas-Junior R, de Lucena CE, Moreira MA, de Moraes VA, Bernardes-Junior JR, da Silva Rocha Vidal C, Ruiz AN, Lucato MT, da Costa NG, Teixeira DA. Sonobreast: predicting individualized probabilities of malignancy in solid breast masses with echographic expression. The breast journal 2011;17:152-9. Peccin S, de Castsro JA, Furlanetto TW, Furtado AP, Brasil BA, Czepielewski MA. Ultrasonography: is it useful in the diagnosis of cancer in thyroid nodules? Journal of endocrinological investigation 2002;25:39-43. Pompili G, Tresoldi S, Primolevo A, De Pasquale L, Di Leo G, Cornalba G. Management of thyroid follicular proliferation: an ultrasound-based malignancy score to opt for surgical or conservative treatment. Ultrasound in medicine & biology 2013;39:1350-5. Quadbeck B, Pruellage J, Roggenbuck U, Hirche H, Janssen OE, Mann K, Hoermann R. Long-term follow-up of thyroid nodule growth. Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association 2002;110:348-54. Rago T, Vitti P, Chiovato L, Mazzeo S, De Liperi A, Miccoli P, Viacava P, Bogazzi F, Martino E, Pinchera A. Role of conventional ultrasonography and color flow-doppler sonography in predicting malignancy in 'cold' thyroid nodules. European journal of endocrinology / European Federation of Endocrine Societies 1998;138:41-6. Regge D, Della Monica P, Galatola G, Laudi C, Zambon A, Correale L, Asnaghi R, Barbaro B, Borghi C, Campanella D, Cassinis MC, Ferrari R, Ferraris A, Hassan C, Golfieri R, Iafrate F, Iussich G, Laghi A, Massara R, Neri E, Sali L, Venturini S, Gandini G. Efficacy of computer-aided detection as a second reader for 6-9-mm lesions at CT colonography: multicenter prospective trial. Radiology 2013;266:168-76. Schlumberger MJ. Papillary and follicular thyroid carcinoma. The New England journal of medicine 1998;338:297-306. SEERCancerStatistics. SEER Cancer Statistics Factsheets: Thyroid Cancer. 2013; Shimamoto K, Endo T, Ishigaki T, Sakuma S, Makino N. Thyroid nodules: evaluation with color Doppler ultrasonography. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine 1993;12:673-8. Sugitani I, Fujimoto Y. Management of low-risk papillary thyroid carcinoma: unique conventional policy in Japan and our efforts to improve the level of evidence. Surgery today 2010;40:199-215. Takashima S, Fukuda H, Nomura N, Kishimoto H, Kim T, Kobayashi T. Thyroid nodules: re-evaluation with ultrasound. Journal of clinical ultrasound : JCU 1995;23:179-84. Taki S, Terahata S, Yamashita R, Kinuya K, Nobata K, Kakuda K, Kodama Y, Yamamoto I. Thyroid calcifications: sonographic patterns and incidence of cancer. Clinical imaging 2004;28:368-71. Tan GH, Gharib H. Thyroid incidentalomas: management approaches to nonpalpable nodules discovered incidentally on thyroid imaging. Annals of internal medicine 1997;126:226-31. Tee YY, Lowe AJ, Brand CA, Judson RT. Fine-needle aspiration may miss a third of all malignancy in palpable thyroid nodules: a comprehensive literature review. Annals of surgery 2007;246:714-20. Tomimori E, Pedrinola F, Cavaliere H, Knobel M, Medeiros-Neto G. Prevalence of incidental thyroid disease in a relatively low iodine intake area. Thyroid : official journal of the American Thyroid Association 1995;5:273-6. Tunbridge WM, Evered DC, Hall R, Appleton D, Brewis M, Clark F, Evans JG, Young E, Bird T, Smith PA. The spectrum of thyroid disease in a community: the Whickham survey. Clinical endocrinology 1977;7:481-93. Unger K, Zitzelsberger H, Salvatore G, Santoro M, Bogdanova T, Braselmann H, Kastner P, Zurnadzhy L, Tronko N, Hutzler P, Thomas G. Heterogeneity in the distribution of RET/PTC rearrangements within individual post-Chernobyl papillary thyroid carcinomas. The Journal of clinical endocrinology and metabolism 2004;89:4272-9. van Ginneken B, Hogeweg L, Prokop M. Computer-aided diagnosis in chest radiography: beyond nodules. European journal of radiology 2009;72:226-30. Vander JB, Gaston EA, Dawber TR. The significance of nontoxic thyroid nodules. Final report of a 15-year study of the incidence of thyroid malignancy. Annals of internal medicine 1968;69:537-40. Vassallo P, Wernecke K, Roos N, Peters PE. Differentiation of benign from malignant superficial lymphadenopathy: the role of high-resolution US. Radiology 1992;183:215-20. Warren Burhenne LJ, Wood SA, D'Orsi CJ, Feig SA, Kopans DB, O'Shaughnessy KF, Sickles EA, Tabar L, Vyborny CJ, Castellino RA. Potential contribution of computer-aided detection to the sensitivity of screening mammography. Radiology 2000;215:554-62. Wienke JR, Chong WK, Fielding JR, Zou KH, Mittelstaedt CA. Sonographic features of benign thyroid nodules: interobserver reliability and overlap with malignancy. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine 2003;22:1027-31. Wiest PW, Hartshorne MF, Inskip PD, Crooks LA, Vela BS, Telepak RJ, Williamson MR, Blumhardt R, Bauman JM, Tekkel M. Thyroid palpation versus high-resolution thyroid ultrasonography in the detection of nodules. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine 1998;17:487-96. Ying M, Ahuja A, Metreweli C. Diagnostic accuracy of sonographic criteria for evaluation of cervical lymphadenopathy. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine 1998;17:437-45. Zhang JZ, Hu B. Sonographic features of thyroid follicular carcinoma in comparison with thyroid follicular adenoma. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine 2014;33:221-7. | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/56270 | - |
dc.description.abstract | 甲狀腺癌是最常見的惡性腫瘤。在近幾十年來,發生率有上升的趨勢。所以,如何提升偵測甲狀腺腫瘤的靈敏度,以及提升診斷的正確率,也就變得越來越重要。在此論文中,我們提出了一個創新的電腦輔助方法,來量化甲狀腺癌的超音波影像特徵。我們主要是針對超音波影像呈現微細鈣化以及不均質迴音兩項特徵進行影像處理以及分析。以驗證我們提出來的創新指標,是否可以提升甲狀腺癌的診斷準確率。
在第一部分針對傳統超音波鈣化的量化,在256個甲狀腺腫瘤(173個良性,83個惡性)的驗證之後,良惡性的腫瘤間有顯著的差異(p<0.001, AUC=0.746)。再針對手術切除後有病理報告證實的腫瘤(102個良性,79個惡性)進行驗證,也得到良惡性的腫瘤間有顯著的差異的結果(p<0.001, AUC=0.763)。研究中也比較電腦量化的超音波指標與傳統超音波鈣化在評估腫瘤上的差異,顯示在惡性腫瘤中,傳統超音波鈣化的比例為48.19(40 of 83)。在良性腫瘤中,傳統超音波鈣化的比例為10.98(19 of 173)。這個研究證實了,電腦量化的超音波鈣化指標,相較於傳統的評估方式,是一個較靈敏較客觀的方式,對甲狀腺癌的診斷,可以提升更靈敏的評估。 在第二部分針對傳統超音波不均質迴音的評估,在400個甲狀腺腫瘤(271個良性,129個惡性)的驗證之後,良惡性的腫瘤間有顯著的差異(p<0.001, AUC=0.714)。在本研究中也證實傳統超音波不均質廻音的評估並無法有效的區分出良惡性腫瘤。而傳統超音波較明顯的不均質廻音,也有較高的電腦量化不均質迴音指標。證實新的指標,相較於傳統超音波不均質廻音,可以更有效分辨良惡性腫瘤。在濾泡腫瘤上,對於濾泡腫瘤的良惡性在術前也可以提供有效的評估。 在我們的研究中,可以觀察到,電腦輔助量化超音波指標,的確可以有效地提升甲狀腺腫瘤的診斷率。未來在臨床上的應用,量化超音波及傳統超音波多指標的統合診斷方式將是可行的發展方向。 | zh_TW |
dc.description.abstract | Thyroid cancer is the most common endocrine malignancy. The incidence is increasing in the past decades. How to improve the detection rate and diagnostic accuracy has become an urgent issue. We proposed the novel computerized methods in this thesis to quantify the ultrasonic features of thyroid cancer. We included two ultrasonic features which were microcalcifications and heterogeneity in this thesis to test whether computerized method could be helpful in diagnosis of thyroid cancer.
The first part was to improve the ultrasonographic detection rates of thyroid cancers with microcalcifications, we proposed to enhance the sensitivity of sonographic calcifications detection and to avoid inter-observer variation by a computerized quantification method in a prospective setting. A total of 256 nodules were included (173 benign, 83 malignant). Among them, the diagnosis of 181 nodules (102 benign, 79 malignant) were verified by surgical pathology. Quantification of cystic components and calcifications was automatically performed by a proprietary program (AmCAD-UT) implemented with methods proposed in this paper. The calcification index (CI) between benign and malignant nodules diagnosed by combined FNA biopsy and surgical pathology results (total number, 256) showed a significant difference (p<0.001, AUC=0.746). Furthermore, we excluded patients without surgical pathology results for further validation, and the CI between benign and malignant nodules confirmed by pathology results (total number, 181) showed a significant difference (p<0.001, AUC=0.763). To learn whether our computer program increased our diagnostic capabilities, we analyzed human investigators and their abilities to detect and evaluate. In this study, calcifications were noted in 48.19% (40 of 83) of malignant thyroid nodules and in 10.98% (19 of 173) of benign nodules. This new computer-aided diagnosis method to evaluate the sonographic calcifications of thyroid nodules is a more sensitive and more objective method. It can provide better sensitivity than conventional methods in the diagnosis of thyroid malignancies containing microcalcifications. The second part is to test whether the computerized quantification of ultrasonic heterogeneity can aid the diagnosis of thyroid malignancy, we evaluated ultrasonic heterogeneity by an objective and quantitative computerized method in a prospective setting. A total of 400 nodules including 271 benign thyroid nodules and 129 malignant thyroid nodules were evaluated. Quantification of ultrasonic heterogeneity (heterogeneity index, HI) was performed by a proprietary program implemented with methods proposed in this paper. The HI values between benign and malignant nodules, diagnosed by a combination of fine-needle aspiration (FNA) and surgical pathology results, are significantly different (p<0.001, AUC=0.714). Ultrasonic heterogeneity (US-H) of these samples assessed by an experienced clinician could not significantly differentiate between benign and malignant thyroid nodules. However, the nodules with marked heterogeneity of US-H showed higher HI values than that of nodules with homogeneous US-H assessment. These results indicate that using the new computer-aided diagnosis method to evaluate the ultrasonic heterogeneity of thyroid nodules is an objective and quantitative method that is correlated to the conventional US-H assessment but can aid in the diagnosis of thyroid malignancy better. | en |
dc.description.provenance | Made available in DSpace on 2021-06-16T05:21:18Z (GMT). No. of bitstreams: 1 ntu-103-D90421102-1.pdf: 2153407 bytes, checksum: 9eb95e5c99eb3d784da7dced60ba4050 (MD5) Previous issue date: 2014 | en |
dc.description.tableofcontents | 口試委員會審定書 4
誌謝 5 中文摘要 6 英文摘要 8 第一章 緒論 11 1.1. 研究背景 11 1.1.1. 甲狀腺癌的發生率 11 1.1.2. 甲狀腺癌的超音波診斷 12 1.2. 研究假說及目的 19 第二章 研究方法與材料 20 2.1. 量化超音波鈣化指標 20 2.1.1. 受試腫瘤 20 2.1.2. 超音波器材 20 2.1.3. 超音波檢查步驟 20 2.1.4. 超音波囊性組成與超音波的鈣化點之量化分析 (Cystic component and calcifications) 21 2.3鈣化指標與不均質指標的比較 27 第三章 結果 28 3.1. 鈣化指標驗證 28 3.1.1. 鈣化指標評估良惡性腫瘤 28 3.1.2. 鈣化指標評估不同大小的腫瘤 28 3.1.3. 鈣化指標評估不同囊性組成比例的腫瘤 28 3.1.4. 鈣化指標與人工的超音波鈣化評估 29 3.2. 不均質指標驗證 30 3.2.1. 不均質指標評估良惡性腫瘤 30 3.2.2. 不均質指標評估不同大小的腫瘤 30 3.2.3. 不均質指標評估不同囊性組成比例的腫瘤 30 3.2.4. 不均質指標與人工的超音波不均質度評估比較 31 3.2.5. 不均質指標在濾泡腫瘤的分析 31 3.3. 鈣化指標與不均質指標的比較 31 第四章 討論 32 第五章 展望 39 第六章 英文部分 41 6.1. Computerized Detection and Quantification of Microcalcifications in Thyroid Nodules 41 6.1.1. Introduction 41 6.1.2. Materials and Methods 43 6.1.3. Results 48 6.1.4. Discussion and Summary 50 6.2. Computerized Quantification of Ultrasonic Heterogeneity in Thyroid Nodules 55 6.2.1. Introduction 55 6.2.2. Materials and Methods 56 6.2.3. Results 62 6.2.4. Discussion 65 6.2.5. Conclusions 70 第七章 圖表 71 7.1. 表 (表1至表7) 71 7.2. 圖 (圖1至圖23) 78 第八章 附錄:博士班修業期間所發表之相關論文 102 第九章 參考文獻 103 | |
dc.language.iso | zh-TW | |
dc.title | 超音波的量化指標在甲狀腺腫瘤診斷的應用 | zh_TW |
dc.title | COMPUTER AIDED ULTRASOUND DIAGNOSIS IN THYROID NODULES | en |
dc.type | Thesis | |
dc.date.schoolyear | 102-2 | |
dc.description.degree | 博士 | |
dc.contributor.oralexamcommittee | 陳炯年(Chiung-Nien Chen),郭博昭(Terry Bo-jau Kuo),成佳憲(Jason Chia-Hsien Cheng),崔博翔(Po-Hsiang Tsui) | |
dc.subject.keyword | 微鈣化,鈣化指數,甲狀腺癌,電腦輔助診斷, | zh_TW |
dc.subject.keyword | Microcalcifications,Calcification index,Thyroid cancer,Computer-aided diagnosis., | en |
dc.relation.page | 109 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2014-08-15 | |
dc.contributor.author-college | 醫學院 | zh_TW |
dc.contributor.author-dept | 臨床醫學研究所 | zh_TW |
顯示於系所單位: | 臨床醫學研究所 |
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