The Current Progress of Artificial Intelligence in Approach to Thyroid Nodules: A Narrative Review

Background: Artificial intelligence (AI) can play a significant role in the future of thyroidology. Thyroid nodules are common conditions that may benefit from AI through more accurate and efficient diagnosis, risk stratification, and medical or surgical management. Objective: This paper aims to review the latest developments in AI applications for diagnosing and managing thyroid nodules and cancers. Methods: English full-text articles published in the PubMed and Google Scholar databases from January 2014 to March 2024 were collected and reviewed to provide a comprehensive understanding of the topic. A total of 45 studies were selected based on relevance, robust methodology, statistical significance, and broader topic coverage. Results: Artificial intelligence has emerged as a powerful tool for managing thyroid nodules. First, several studies have demonstrated how AI-powered ultrasound interpretation enhances the diagnosis and classification of nodules while reducing the need for invasive fine-needle aspiration (FNA) biopsies. Second, AI significantly improves the cytopathological differentiation between benign and malignant thyroid nodules by minimizing reliance on pathologists' expertise and implementing standardized diagnostic criteria. When cytopathology is inconclusive, AI also aids in identifying molecular markers from omics data, distinguishing between normal and cancerous cells. Moreover, AI tools have been developed for prognosis assessment, predicting distant metastasis, recurrence, and surveillance by integrating medical imaging features with molecular and clinical factors. Additionally, some AI tools are designed for intraoperative evaluation, improving surgical techniques and reducing complications during thyroidectomy. In non-surgical treatments, several models have been developed to optimize therapeutic doses of radioactive iodine (RAI) and predict the outcomes of new drug formulations. Conclusions: Artificial intelligence has the potential to assist physicians in accurate thyroid nodule diagnosis, classification, decision-making, optimizing treatment strategies, and improving patient outcomes. However, there are still limitations to this technology. Artificial intelligence-driven tools require further advancements before they can be fully integrated into clinical practice and replace specialists.