AbstractPurposeAssessment of thyroid nodules is usually relied on the experience of the radiologist and is time‐consuming. Classification model of thyroid nodules cannot only reduce the burden on physicians but also provide objective recommendations. However, most classification models based on deep learning simply give a prediction result of the benignity or malignancy of nodules; thus, physicians have no way of knowing how the deep learning gets the prediction result due to the black‐box nature of neural networks. In this work, we integrate the explainability directly into the outputs generated by the model through combining thyroid imaging reporting and data system (TI‐RADS). The inference process of the proposed method is consistent with doctor's clinical diagnosis process; therefore, doctors can better explain the diagnosis results of the model to the patient.MethodsA multitask network based on TI‐RADS (MTN‐TI‐RADS) for the classification of thyroid nodules is proposed. In this network, a set of TI‐RADS classifications of nodules is first obtained by multitask learning, then the TI‐RADS points and the corresponding risk levels are calculated, and finally, nodules are classified as benign and malignant. The classification process through the network is consistent with the diagnostic process of physician; thus, the results of classification can be easily understood by physicians. In addition, the attention modules are introduced to the spatial and channel domains to let the network focus more on critical features.ResultsTo verify the classification performance of our method, we compared the results obtained through our method with the results of the radiologist's evaluation. For the 781 test nodules in the internal dataset and the 886 test nodules in the external dataset, the sensitivity and specificity of MTN‐TI‐RADS were 0.988, 0.912 in internal dataset, 0.949, 0.930 in external dataset, versus the senior radiologist of 0.925 (), 0.816 (), and 0.910 (), 0.836 (), respectively. And the area under the receiver operating characteristic curve of MTN‐TI‐RADS was 0.981 in internal dataset, 0.973 in external dataset, versus the senior radiologist of 0.905, 0.923. For the internal dataset, we also computed the accuracy of the risk level (TR1 to TR5) and the mean absolute error (MAE). The accuracy of the risk level of the proposed method is 78%, and the MAE is 1.30. The MAE of the total points (0–14 points) is 1.30.ConclusionsAn effective and result‐interpretable end‐to‐end thyroid nodule classification network (MTN‐TI‐RADS) is proposed. MTN‐TI‐RADS has superior ability to classify malignant and benign thyroid nodules compared to senior radiologists. Based on MTN‐TI‐RADS, a classification model with strong interpretation and a high degree of physician trust is constructed. The proposed classification network is consistent with the diagnosis process of physicians, thus is more reliable and interpretable, and has great potential for clinical application.