This work aimed to analyze the effect of the boundary segmentation algorithm in thyroid nodules image segmentation and the influence of its adoption in avoiding recurrent laryngeal nerve (RLN) injury during treatment of thyroid nodules. The nodule boundary was extracted aided by the local Gaussian distribution fitting energy (LGDF) segmentation algorithm, which was compared with the normalized cut (Ncut) algorithm and the Canny algorithm. Then, 51 patients treated with microwave ablation for thyroid nodules were taken as a test group, and 51 patients treated with surgical resection were taken as a control group. The incidence of RLN injury and the levels of free triiodothyronine (FT₃), free thyroid hormone (FT₄), and thyroid-stimulating hormone (TSH) were compared between the two groups before and after treatment. The results showed that the true positive fraction (TPF) of the LGDF segmentation algorithm was 69.45%, the TPF of the Ncut algorithm and the Canny algorithm were 58.65% and 52.37%, respectively. The TPF of LGDF algorithm was higher than that of the Ncut algorithm and Canny algorithm, with notable differences (). In the control group, there were 10 cases of temporary and permanent damage to the RLN after operation, and the total incidence was 19.61%. In the test group, there were 3 cases of temporary and permanent damage to the RLN after operation, and the total incidence was 5.88%, which was lower than that of the control group (). No evident differences were shown in the levels of FT₃, FT₄, and TSH between the two groups before treatment (). However, after treatment, the TSH level of the test group (4.58 ± 0.79) was higher than that of the control group (3.19 ± 0.17), and the levels of FT₃ and FT₄ in the test group were lower than those in the control group, and the differences were remarkable (). In short, the LGDF algorithm had more ideal segmentation effect. In addition, ultrasound-guided microwave ablation was effective in treating benign thyroid nodules, which could reduce damage to the RLN and maintain normal thyroid function.

中文翻译：

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超声图像局部高斯分布拟合边界图像分割算法在甲状腺结节治疗中避免喉返神经损伤

【摘要】：目的分析边界分割算法在甲状腺结节图像分割中的作用及其在甲状腺结节治疗过程中避免喉返神经损伤的影响。在局部高斯分布拟合能量（LGDF）分割算法的辅助下提取结节边界，并与归一化切割（Ncut）算法和Canny算法进行比较。再以甲状腺结节微波消融术51例为试验组，手术切除术51例为对照组。RLN损伤发生率与游离三碘甲腺原氨酸（FT ₃）、游离甲状腺激素（FT _{4 ）水平})、治疗前后两组间促甲状腺激素(TSH)进行比较。结果表明，LGDF分割算法的真阳性率（TPF）为69.45%，Ncut算法和Canny算法的TPF分别为58.65%和52.37%。LGDF算法的TPF高于Ncut算法和Canny算法，差异显着（）。对照组术后RLN出现暂时性和永久性损伤10例，总发生率为19.61%。试验组术后RLN出现暂时性和永久性损伤3例，总发生率为5.88%，低于对照组（）。两组治疗前FT ₃、FT ₄、TSH水平无明显差异（）。但治疗后，试验组TSH水平（4.58±0.79）高于对照组（3.19±0.17），试验组FT ₃和FT ₄水平低于对照组。对照组，差异显着（）。总之，LGDF算法具有更理想的分割效果。此外，超声引导下的微波消融治疗良性甲状腺结节有效，可减少对RLN的损伤，维持正常甲状腺功能。