Application of a Novel Multimodal-Based Deep Learning Model for the Prediction of Papillary Thyroid Carcinoma Recurrence

Dong-Hwa Lee,1,* Jee-Woo Choi,2,* Geun-Hyeong Kim,2 Seung Park,3 Hyun Jeong Jeon1 1Department of Internal Medicine, Chungbuk National University College of Medicine and Chungbuk National University Hospital, Cheongju, South Korea; 2Medical AI Research Team, Chungbuk National University Hospital, Cheongju, South Korea; 3Biomedical Engineering, Chungbuk National University Hospital, Cheongju, South Korea*These authors contributed equally to this workCorrespondence: Hyun Jeong Jeon, Department of Internal Medicine, Chungbuk National University College of Medicine 1 Chungbuk National University Hospital, 776, 1 Sunhwan-ro, Seowon-gu, Cheongju-si, Chungcheongbuk-do, Cheongju, 28644, South Korea, Tel +82-43-269-6352, Fax +82-43-273-6029, Email [email protected] Seung Park, Department of Biomedical Engineering, Chungbuk National University Hospital, 776, 1 Sunhwan-ro, Seowon-gu, Cheongju-si, Chungcheongbuk-do, Cheongju, 28644, South Korea, Email [email protected]: Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy. Although its mortality rate is low, some patients experience cancer recurrence during follow-up. In this study, we investigated the accuracy of a novel multimodal model by simultaneously analyzing numeric and time-series data to predict recurrence in patients with PTC after thyroidectomy.Patients and Methods: We analyzed patients with thyroid carcinoma who underwent thyroidectomy at the Chungbuk National University Hospital between January 2006 and December 2021. The proposed model used numerical data, including clinical information at the time of surgery, and time-series data, including postoperative thyroid function test results. For the model training with unbalanced data, we employed weighted binary cross-entropy with weights of 0.8 for the positive (recurrence) group and 0.2 for the negative (nonrecurrence) group. We performed four-fold cross-validation of the dataset to evaluate the model performance.Results: Our dataset comprised 1613 patients who underwent thyroidectomy, including 1550 and 63 patients with nonrecurrent and recurrent PTC, respectively. Patients with recurrence had a larger tumor size, more tumor multiplicity, and a higher male-to-female ratio than those without recurrence. The proposed model achieved an average area under the curve of 0.9622, F1-score of 0.4603, sensitivity of 0.9042, and specificity of 0.9077.Conclusion: When applying our proposed model, the experimental results showed that it could predict recurrence at least 1 year before occurrence. The multimodal model for predicting PTC recurrence after thyroidectomy showed good performance. In clinical practice, it may help with the early detection of recurrence during the follow-up of patients with PTC after thyroidectomy.Keywords: follow-up, malignancy, thyroidectomy, thyroid cancer