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  • br Results The sensitivity specificity and


    Results: The sensitivity, specificity and accuracy of nodule classification based on analysis of external characteristics were 100%, 95.45% and 97.78%, respectively, whereas classification results based on inter-nal characteristics were 95.35%, 90.91% and 94.44%, respectively. Conclusion: A computer-aided diagnosis (CADx) for thyroid cancer system based on analysis of external and internal characteristics has been developed. The sensitivity, specificity and level of accuracy for both characteristics showed that the proposed system was reliable to assist radiologist in classifying thyroid nodules.
    2019 The Authors. Production and hosting by Elsevier B.V. on behalf of King Saud University. This is an open access article under the CC BY-NC-ND license (
    1. Introduction
    Thyroid cancer is one of the fastest growing cancers in the world. In the US, it N,N-Dimethylsphingosine has become the most rapidly increasing cancer in the past three decades (Sencha et al., 2011). Much of this rise in detection appears to be the result of the increased use of thyroid
    ⇑ Corresponding author.
    E-mail addresses: [email protected] (H.A. Nugroho), [email protected] (Zulfanahri), [email protected] (E.L. Frannita), [email protected] (I. Ardiyanto), [email protected] (L. Choridah).
    q This work is funded by Indonesian Endowment Fund for Education (LPDP) and Directorate General of Higher Education, Ministry of Research, Technology and Higher Education, Republic of Indonesia through the Research Grant ‘‘Penelitian Tim Pasca Sarjana”.
    Peer review under responsibility of King Saud University.
    Production and hosting by Elsevier
    ultrasound, which can detect small thyroid nodules that might not otherwise have been found in the past. A study predicted that thyroid cancer would become the third most common cancer in women in the United States by 2019 (Haugen et al., 2016). National Cancer Institute in the US stated that prevalence of thyroid cancer occurred in women with a comparison to men was three to one (N. C. Institute). These made the thyroid cancer one of the women dis-eases to be prevented. Currently, in Indonesia, thyroid cancer is ranked in the ninth place of all cancer that happened to men and women, while in the USA it is ranked in the eleventh position (N. C. Institute; Indonesia, 2015). Thyroid cancer can occur in any group of age, but it commonly occurs after the age of thirty and it increases significantly in older people (N.C. Institute; K.K.R. Indonesia, 2015; A.C. Society, 2017).
    Thyroid nodule is located in a thyroid gland. The thyroid gland is not palpable in normal condition. The nodule itself is frequently present without any symptom depending on the malignancy of the nodule, but it is still possible to manifest symptoms such as hoarseness (due to voice nerve destruction), breathing difficulty (due to underlying wind pipe obstruction by the gland),
    This is an open access article under the CC BY-NC-ND license (
    Please cite this article as: H. A. Nugroho, Zulfanahri, E. L. Frannita et al., Computer aided diagnosis for thyroid cancer system based on internal and external characteristics, Journal of King Saud University – Computer and Information Sciences
    2 H.A. Nugroho et al. / Journal of King Saud University – Computer and Information Sciences xxx (xxxx) xxx
    swallowing discomfort (due to the size of the nodule) or an upper neck swelling (due to spread of the nodule to the neck lymph glands). Fig. 1 shows the picture of thyroid gland, ultrasound guided fine needle aspiration biopsy (FNAB) and ultrasound finding of thyroid cystic lesion.
    Several examinations are conducted for thyroid nodules such as MRI, CT scan, ultrasonography, and so forth. However, ultrasound images are the most widely used to examine thyroid nodules which are usually followed by FNAB to support the diagnosis. MRI and CT scan are mostly used to monitor and examine the metastasis of the lesion (Kim et al., 2002).