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Thyroid CancerNCT06498674

AI-Assisted Ultrasound Review Before Thyroid Surgery

A study testing Locked AI-Assisted Thyroid Ultrasound Repeat Examination and Review in people with Thyroid Cancer and Thyroid Nodule, run by Fujian Medical University at 1 site in China.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This prospective, single-center, single-arm study evaluates a locked artificial intelligence (AI) system as a surgeon-led second-read tool before thyroid surgery. Eligible participants scheduled for thyroid surgery undergo standard ultrasonography followed by a standardized AI-assisted repeat examination. Read more about this study

Who is it for?
Any age
Conditions the study is for
Thyroid Cancer, Thyroid Nodule
What is being tested?
Locked AI-Assisted Thyroid Ultrasound Repeat Examination and Review
Could I receive a placebo?
No, everyone receives an active treatment
How many people
515 participants
Where
1 siteChina
Study dates
1 Sep 2024to 15 Oct 2025
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Patients with preoperative pathological confirmation of thyroid malignant tumors undergoing surgical treatment.
  • Patients with benign thyroid tumors, such as thyroid adenomas causing compressive symptoms, undergoing surgical treatment.
  • Patients with complete and high-quality traditional two-dimensional color ultrasound images.
  • Complete postoperative pathology reports.
  • Willingness to participate in this clinical trial and signing of informed consent.

Who cannot join

  • Patients with a history of neck surgery or radiotherapy.
  • Patients with a history of malignant tumors in other parts of the body.
  • Patients with thyroid dysfunction.
  • Incomplete or poor-quality traditional two-dimensional color ultrasound images.
  • Incomplete postoperative pathology reports.
  • Refusal to participate in this clinical trial.

Trial locations and contacts

1 site in 1 country.

China1 site
  • Fujian Medical University Union Hospital

    Fuzhou, Fujian, 350001

Other trials in China

About this study

Official title: Clinical Application of AI-assisted Ultrasound Technology in the Preoperative Evaluation of Thyroid Cancer

This prospective, single-center, single-arm study evaluates a locked artificial intelligence (AI) system as a surgeon-led second-read tool before thyroid surgery. Eligible participants scheduled for thyroid surgery undergo standard ultrasonography followed by a standardized AI-assisted repeat examination. The AI system evaluates thyroid nodules only; cervical lymph nodes are assessed by clinicians. The study assesses participant-level supplementary pathological examinations and treatment-decision changes and evaluates nodule-level diagnostic performance against final surgical histopathology.

Read the detailed description

This prospective, single-center, single-arm study evaluates a locked AI-assisted ultrasound system used during surgeon-led preoperative review in participants scheduled for thyroid surgery. Each participant undergoes standard preoperative ultrasonography followed by a standardized AI-assisted repeat examination. The locked system provides thyroid-nodule malignancy scores and classifications; it was not retrained or recalibrated during the study and did not assess cervical lymph nodes. Clinicians integrate standard ultrasound, cytology, clinical findings, and other information and retain responsibility for all supplementary examinations and final management decisions. The two primary outcomes are participant-level: (1) whether a participant undergoes an additional cytologic or pathologic examination and (2) whether a participant has at least one change in planned surgical management. Participants are counted once within each outcome, while event counts may be summarized separately. The embedded diagnostic analysis is nodule-level and uses unambiguously pathology-matched surgical histopathology as the reference standard. Only nodules with a definitive benign or malignant surgical histopathological diagnosis are included in binary diagnostic-performance calculations. Low-risk or borderline thyroid neoplasms, including follicular tumors of uncertain malignant potential (FT-UMP), well-differentiated tumors of uncertain malignant potential (WDT-UMP), and non-invasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTP), and nodules without unambiguous lesion-level linkage are excluded from binary reference-standard analyses. These post-enrollment analysis exclusions do not alter the 515-participant actual enrollment or the participant-level workflow cohort. A participant may contribute another eligible nodule if that lesion has an unambiguous definitive diagnosis. Cervical lymph-node pathology is described only for nodes actually removed or sampled; no reference diagnosis is assigned to unsampled nodes.

Being tested
Locked AI-Assisted Thyroid Ultrasound Repeat Examination and Review
Keywords
Thyroid Cancer, Artificial Intelligence, Ultrasound, Preoperative Assessment
Medical subject headings
Thyroid Neoplasms, Thyroid Nodule

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Locked AI-Assisted Thyroid Ultrasound Repeat Examination and ReviewDiagnostic test

    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.

Study groups in NCT06498674
Study groupRoleWhat they receive
AI-Assisted Preoperative ReviewExperimentalParticipants 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.
Receives: Diagnostic Test: Locked AI-Assisted Thyroid Ultrasound Repeat Examination and Review

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Proportion of Participants Undergoing Supplementary Cytologic or Pathologic Examination

    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.

    Measured: From completion of the AI-assisted repeat examination through completion of surgery

  2. Proportion of Participants With a Change in Planned Surgical Management

    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.

    Measured: From completion of the AI-assisted review through surgery

Secondary outcomes (13)
  1. Distribution of C-TIRADS Categories Among Evaluated Thyroid Nodules

    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.

    Measured: During standard preoperative ultrasonography, before the AI-assisted repeat examination

  2. Proportion of Evaluated Thyroid Nodules Classified as AI-Positive

    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.

    Measured: During the preoperative AI-assisted repeat examination, before surgery

  3. Results of Supplementary Cytologic or Pathologic Examinations

    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.

    Measured: From supplementary sampling to availability of the corresponding result, before or during surgery

  4. Final Histopathological Diagnosis of Resected Thyroid Nodules

    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.

    Measured: From surgery until the final postoperative histopathology report became available; assessed through October 15, 2025, over the approximately 14-month study period.

  5. Nodule-Level Sensitivity of AI and C-TIRADS

    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.

    Measured: From the preoperative examinations until the final postoperative histopathology report became available; assessed through October 15, 2025, over the approximately 14-month study period.

  6. Nodule-Level False-Negative Rate of AI and C-TIRADS

    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.

    Measured: From the preoperative examinations until the final postoperative histopathology report became available; assessed through October 15, 2025, over the approximately 14-month study period.

  7. Nodule-Level Positive Predictive Value of AI and C-TIRADS

    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.

    Measured: From the preoperative examinations until the final postoperative histopathology report became available; assessed through October 15, 2025, over the approximately 14-month study period.

  8. Nodule-Level Youden Index of AI and C-TIRADS

    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.

    Measured: From the preoperative examinations until the final postoperative histopathology report became available; assessed through October 15, 2025, over the approximately 14-month study period.

  9. Distribution of Cervical Lymph-Node Metastasis Status Among Pathologically Examined Nodes

    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.

    Measured: From surgery or supplementary sampling until the corresponding pathology result became available; assessed through October 15, 2025, over the approximately 14-month study period.

  10. Nodule-Level Specificity of AI and C-TIRADS

    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.

    Measured: From the preoperative examinations until the final postoperative histopathology report became available; assessed through October 15, 2025, over the approximately 14-month study period.

  11. Nodule-Level Negative Predictive Value of AI and C-TIRADS

    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.

    Measured: From the preoperative examinations until the final postoperative histopathology report became available; assessed through October 15, 2025, over the approximately 14-month study period.

  12. Nodule-Level Accuracy of AI and C-TIRADS

    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.

    Measured: From the preoperative examinations until the final postoperative histopathology report became available; assessed through October 15, 2025, over the approximately 14-month study period.

  13. Area Under the ROC Curve for the Continuous AI Malignancy Score

    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.

    Measured: From the preoperative examinations until the final postoperative histopathology report became available; assessed through October 15, 2025, over the approximately 14-month study period.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted12 Jul 2024
  2. Study start1 Sep 2024
  3. Primary completion28 Sep 2025
  4. Study completion15 Oct 2025

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Diagnosis
Allocation
Not applicable
Intervention model
Single group
Model description
All enrolled participants underwent the same surgeon-led workflow: standard preoperative ultrasound followed by review of a locked AI nodule-assessment output. Concordant and discordant findings were workflow strata, not assigned study arms. Additional pathological examination and management changes were clinician directed.
Masking
None (open label)
Enrolment
515 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06498674
Sponsor's protocol ID
AI-base PCD
Status last verified
Aug 2026
First submitted
9 Jun 2024
Last updated
7 Aug 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: 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.

Questions about this trial

What is this clinical trial studying?

A study testing Locked AI-Assisted Thyroid Ultrasound Repeat Examination and Review in people with Thyroid Cancer and Thyroid Nodule, run by Fujian Medical University at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 7 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Proportion of Participants Undergoing Supplementary Cytologic or Pathologic Examination (time frame: From completion of the AI-assisted repeat examination through completion of surgery). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Aug 2026.

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