Arshbir Aulakh, Masih Sarafan, Amardeep S Sekhon, Khanh Linh Tran, Ameen Amanian, Farahna Sabiq, Cornelius Kürten, Eitan Prisman
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引用次数: 0
Abstract
Objective: To evaluate the clinical utility of machine learning algorithms (MLAs) in diagnosing extra-nodal extension (ENE) using CT imaging in HNSCC.
Data sources: A comprehensive literature search was conducted on MEDLINE (Ovid), EMBASE, Cochrane, Scopus, and Web of Science, from January 1, 2000, to February 12, 2025.
Review methods: Two independent reviewers selected studies reporting the diagnostic accuracy of MLAs in detecting ENE in patients with HNSCC. The review followed PRISMA guidelines. Meta-analysis was performed using MedCalc (23.0.2), with pooled estimates of the area under the curve (AUC) and corresponding 95% confidence intervals (CI) calculated. The Checklist for Artificial Intelligence in Medical Imaging (CLAIM) was used to analyze the methodological quality of the included studies.
Results: Of 57 articles retrieved, six met inclusion criteria, encompassing 2870 lymph nodes from 1407 patients. MLAs achieved a pooled AUC of 0.92 (95% CI [0.915, 0.923], p < 0.001; fixed-effects) and 0.91 (95% CI [0.882, 0.929], p < 0.001; random-effects), outperforming radiologists who had pooled AUCs of 0.65 (95% CI [0.645-0.654], p < 0.001; fixed-effects) and 0.65 (95% CI [0.591-0.708], p < 0.001; random-effects). Furthermore, MLA achieved a sensitivity ranging from 66.9% to 91.2%, compared to 24% to 96.0% by radiologists. The specificity and accuracy of MLA ranged from 72% to 96.2% and 66% to 92.2%, respectively, compared to that of radiologists, which ranged from 43.0% to 96.0% and 51.5% to 88.6%, respectively.
Conclusion: MLAs demonstrate superior diagnostic performance in predicting ENE in HNSCC and may serve as a valuable adjunct to radiologists in clinical practice.
期刊介绍：
The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope.
• Broncho-esophagology
• Communicative disorders
• Head and neck surgery
• Plastic and reconstructive facial surgery
• Oncology
• Speech and hearing defects
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