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Zeng S, Liu Y, Duan X, Zhao X, Sun X, Zhang F. Artificial Intelligence in CT for Predicting Cervical Lymph Node Metastasis in Papillary Thyroid Cancer Patients: A Meta-analysis. Acad Radiol 2025; 32:2554-2568. [PMID: 40000328 DOI: 10.1016/j.acra.2025.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2025] [Revised: 02/05/2025] [Accepted: 02/05/2025] [Indexed: 02/27/2025]
Abstract
PURPOSE This meta-analysis aims to evaluate the diagnostic performance of CT-based artificial intelligence (AI) in diagnosing cervical lymph node metastasis (LNM) of papillary thyroid cancer (PTC). METHODS A systematic search was conducted in PubMed, Embase, and Web of Science databases through December 2024, following PRISMA-DTA guidelines. Studies evaluating CT-based AI models for diagnosing cervical LNM in patients with pathologically confirmed PTC were included. The methodological quality was assessed using a modified QUADAS-2 tool. A bivariate random-effects model was used to calculate pooled sensitivity, specificity, and area under the curve (AUC). Heterogeneity was evaluated using I2 statistics, and meta-regression analyses were performed to explore potential sources of heterogeneity. RESULTS 17 studies comprising 1778 patients in internal validation sets and 4072 patients in external validation sets were included. In internal validation sets, AI demonstrated a sensitivity of 0.80 (95% CI: 0.71-0.86), specificity of 0.79 (95% CI: 0.73-0.84), and AUC of 0.86 (95% CI: 0.83-0.89). Radiologists suggested comparable performance with sensitivity of 0.77 (95% CI: 0.64-0.87), specificity of 0.79 (95% CI: 0.72-0.85), and AUC of 0.85 (95% CI: 0.81-0.88). Subgroup analyses revealed that deep learning methods outperformed machine learning in sensitivity (0.86 vs 0.72, P<0.05). No significant publication bias was found in internal validation sets for AI diagnosis (P=0.78). CONCLUSION CT-based AI showed comparable diagnostic performance to radiologists for detecting cervical LNM in PTC patients, with deep learning models showing superior sensitivity. AI could potentially serve as a valuable diagnostic support tool, though further prospective validation is warranted. Limitations include high heterogeneity among studies and insufficient external validation in diverse populations.
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Affiliation(s)
- Sixun Zeng
- School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China (S.Z., Y.L., X.D., X.Z., F.Z.)
| | - Yingxian Liu
- School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China (S.Z., Y.L., X.D., X.Z., F.Z.)
| | - Xinyi Duan
- School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China (S.Z., Y.L., X.D., X.Z., F.Z.)
| | - Xin Zhao
- School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China (S.Z., Y.L., X.D., X.Z., F.Z.)
| | - Xiangjuan Sun
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China (X.S.)
| | - Fenghua Zhang
- School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China (S.Z., Y.L., X.D., X.Z., F.Z.).
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Miao S, Xuan Q, Huang W, Jiang Y, Sun M, Qi H, Li A, Liu Z, Li J, Ding X, Wang R. Multi-region nomogram for predicting central lymph node metastasis in papillary thyroid carcinoma using multimodal imaging: A multicenter study. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2025; 261:108608. [PMID: 39827707 DOI: 10.1016/j.cmpb.2025.108608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2024] [Revised: 12/10/2024] [Accepted: 01/15/2025] [Indexed: 01/22/2025]
Abstract
BACKGROUND AND OBJECTIVE Central lymph node metastasis (CLNM) is associated with high recurrence rate and low survival in patients with papillary thyroid carcinoma (PTC). However, there is no satisfactory model to predict CLNM in PTC. This study aimed to integrate PTC deep learning feature based on ultrasound (US) images, fat radiomics features based on computed tomography (CT) images and clinical characteristics to construct a multimodal and multi-region nomogram (MMRN) for predicting the CLNM in PTC. METHODS We enrolled 661 patients diagnosed with PTC by thyroidectomy from two independent centers. Patients were divided into the primary cohort, internal test cohort (ITC), and external test cohort (ETC), and collected their US images and CT images. Resnet50 was employed to predict the CLNM status of PTC based on US images. Using radiomics feature extraction methods to extract fat radiomics features from CT images. Feature selection was conducted using the least absolute shrinkage and selection operator (LASSO) regression. The predictive performance of the MMRN was evaluated using five-fold cross-validation. We comprehensively evaluated the DLRCN and compared it with five radiologists. RESULTS In the ITC and ETC, the area under the curves (AUCs) of MMRN were 0.829 (95 % CI: 0.822, 0.835) and 0.818 (95 % CI: 0.808, 0.828). The calibration curve revealed good predictive accuracy between the actual probability and predicted probability (P > 0.05). Decision curve analysis showed that the MMRN was clinically useful. Under equal specificity or sensitivity, the performance of MMRN increased by 6.5 % or 2.9 % compared to radiologist assessments. The incorporation of fat radiomics features led to significant net reclassification improvement (NRI) and integrated discrimination improvement (IDI) (NRI=0.174, P < 0.05, IDI=0.035, P < 0.05). CONCLUSION The MMRN demonstrated good performance in predicting the CLNM status of PTC, which was comparable to radiologist assessments. The fat radiomics features exhibited supplementary value for predicting CLNM in PTC.
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Affiliation(s)
- Shidi Miao
- School of Computer Science and Technology, Harbin University of Science and Technology, Harbin, China
| | - Qifan Xuan
- School of Computer Science and Technology, Harbin University of Science and Technology, Harbin, China
| | - Wenjuan Huang
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, NO.150 Haping ST, Nangang District, Harbin 150081, China
| | - Yuyang Jiang
- School of Computer Science and Technology, Harbin University of Science and Technology, Harbin, China
| | - Mengzhuo Sun
- School of Computer Science and Technology, Harbin University of Science and Technology, Harbin, China
| | - Hongzhuo Qi
- School of Computer Science and Technology, Harbin University of Science and Technology, Harbin, China
| | - Ao Li
- School of Computer Science and Technology, Harbin University of Science and Technology, Harbin, China
| | - Zengyao Liu
- Department of Interventional Medicine, The First Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Jing Li
- Department of Geriatrics, The Second Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Xuemei Ding
- School of Computing, Engineering & Intelligent Systems, Ulster University, Northern Ireland, BT48 7JL, United Kingdom
| | - Ruitao Wang
- Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, NO.150 Haping ST, Nangang District, Harbin 150081, China.
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Sun X, Wei Z, Luo Y, Wang M. Exploration of the Evaluation Value of Combined Magnetic Resonance Imaging and Ultrasound Blood Flow Parameters in Cervical Lymph Node Metastasis of Thyroid Cancer. Cancer Manag Res 2025; 17:651-659. [PMID: 40130003 PMCID: PMC11932127 DOI: 10.2147/cmar.s505730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2024] [Accepted: 03/05/2025] [Indexed: 03/26/2025] Open
Abstract
Background Thyroid cancer exhibits the highest cervical lymph node metastasis rate (20-50%) among head and neck malignancies, with occult metastasis occurring in 30-80% of papillary carcinoma cases. However, conventional single-modality imaging faces certain challenges: MRI has limited sensitivity for detecting micro-metastases (<2mm), while Doppler ultrasound may overlook metastases in isoechoic lymph nodes. Therefore, it is crucial to evaluate the diagnostic value of combining MRI and CDUS. This study aims to retrospectively analyze the diagnostic value of combining MRI and CDUS blood flow parameters in detecting cervical lymph node metastasis in thyroid cancer and to compare the diagnostic performance with MRI or CDUS alone. Objective To analyze the evaluation value of combining MRI and color Doppler ultrasound (CDUS) blood flow parameters in detecting cervical lymph node metastasis of thyroid cancer, particularly for occult metastases. Methods A retrospective analysis was conducted on 263 thyroid cancer patients (June 2022-June 2024). Diagnostic consistency between MRI, CDUS parameters (resistive index, pulsatility index, vascular patterns) and pathology were compared. Multimodal evaluation criteria were established: (1) MRI positive signs (lymph node diameter >8mm, cystic change, enhancement heterogeneity) (2) CDUS thresholds (RI≥0.75, PI≥1.25 with chaotic vascularity). Results Among 263 patients, 98 had pathologically confirmed metastases. CDUS showed higher consistency with pathology (Kappa=0.783) than MRI (Kappa=0.645). Combined modality achieved 94.9% sensitivity vs 86.7% (CDUS) and 78.6% (MRI), with accuracy improving from 82.1%/75.3% to 89.4% (P<0.05). Notably, 12/22 occult metastases (≤3mm) were only detected by combined approach. Conclusion The synergistic combination leverages MRI's structural characterization and CDUS's hemodynamic sensitivity, effectively overcoming single-modality limitations in detecting micro-metastases. This dual-assessment protocol addresses thyroid cancer's propensity for early lymphatic spread, providing critical preoperative staging guidance.
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Affiliation(s)
- Xiaosong Sun
- Department of Thyroid-Head & Neck Surgery, Jilin Cancer Hospital, Changchun, People’s Republic of China
| | - Zhengchao Wei
- Department of Thyroid-Head & Neck Surgery, Jilin Cancer Hospital, Changchun, People’s Republic of China
| | - Yiqiang Luo
- Department of Preventive Health Care, Jilin Cancer Hospital, Changchun, People’s Republic of China
| | - Ming Wang
- Department of Thyroid-Head & Neck Surgery, Jilin Cancer Hospital, Changchun, People’s Republic of China
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Gao Y, Chen J, Fu T, Gu Y, Du W. Quantitative analysis of studies that use artificial intelligence on thyroid cancer: a 20-year bibliometric analysis. Front Oncol 2025; 15:1525650. [PMID: 40171256 PMCID: PMC11958942 DOI: 10.3389/fonc.2025.1525650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2024] [Accepted: 02/27/2025] [Indexed: 04/03/2025] Open
Abstract
In recent years, with the rapid advancement of computer science, artificial intelligence has found extensive applications and has been the subject of significant research within the healthcare industry, particularly in areas such as medical imaging, diagnostics, biomedical engineering, and health data analytics. Artificial intelligence has also made considerable inroads in the diagnosis and treatment of thyroid cancer. This study aims to evaluate the progress, current hotspots, and potential future directions of research on artificial intelligence in the field of thyroid cancer through a bibliometric analysis. This study retrieved literature on the application of artificial intelligence in thyroid cancer from 2004 to 2024 from the Web of Science Core Collection (WoSCC) database. A retrospective bibliometric analysis and visualization study of the filtered data were conducted using VOSviewer, CiteSpace, and the Bibliometrix package in R software. A total of 956 articles from 70 countries/regions were included. China had the highest number of publications, with Shanghai Jiao Tong University (China) being the most prolific research institution. The most prolific author was Wei, X. (n=14), while Haugen, B. R. was the most co-cited author (n=297). The Frontiers in Oncology (35 articles, IF=3.5, Q1) was the most frequently publishing journal, and Thyroid (cited 1,705 times) was the most co-cited journal. Keywords such as 'ultrasound,' 'deep learning,' and 'diagnosis' indicate research hotspots in this field. This study provides a comprehensive exposition of the current advancements, emerging trends, and future directions of artificial intelligence in thyroid cancer research. It serves as a valuable resource for clinicians and researchers, offering a systematic understanding of key focal areas in the field, thereby assisting in the identification and determination of future research trajectories.
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Affiliation(s)
| | | | | | | | - WeiDong Du
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang
Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China
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Wang W, Jin F, Song L, Yang J, Ye Y, Liu J, Xu L, An P. Prediction of peripheral lymph node metastasis (LNM) in thyroid cancer using delta radiomics derived from enhanced CT combined with multiple machine learning algorithms. Eur J Med Res 2025; 30:164. [PMID: 40075509 PMCID: PMC11905534 DOI: 10.1186/s40001-025-02438-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2025] [Accepted: 03/06/2025] [Indexed: 03/14/2025] Open
Abstract
OBJECTIVES This study aimed to develop a model for predicting peripheral lymph node metastasis (LNM) in thyroid cancer patients by combining enhanced CT radiomic features with machine learning algorithms. It increased the clinical utility and interpretability of the predictions through SHAP (SHapley Additive exPlanation) values and nomograms for model explanation and visualization. METHODS Clinical and enhanced CT image data from 375 patients with thyroid cancer confirmed by postoperative pathology at Xiangyang No. 1 People's Hospital were collected from January 2015 to July 2023. Among them, there were 88 patients in the LNM group and 287 patients in the non-LNM group. The delta radiomic features of the tumours were extracted. Various machine learning algorithms (such as SVM, GBM, RF, XGBoost, KNN, and LightGBM) were trained on the clinical and radiomic feature data sets and used to construct a reliable prediction model. During model training, cross-validation was used to evaluate model performance, and the optimal model was selected. In addition, SHAP values were used to interpret the prediction results of the optimal model, analyse the contribution of each feature to the prediction results, and further develop a nomogram to visually display the prediction results. RESULTS Univariate analysis confirmed that sex, Hashimoto's disease, tumour adjacency to the thyroid capsule, pathological subtype, Delta Radscore, and Radscore 1 are risk factors for peripheral lymph node metastasis in thyroid cancer patients. The machine learning model based on enhanced CT radiomics performed well in predicting peripheral lymph node metastasis in thyroid cancer patients. In the test set, the optimal model, SVM, achieved high AUC (0.879), sensitivity (0.849), and specificity (0.769) values. Through SHAP value analysis, the importance and contribution of tumour adjacency to the thyroid capsule, pathological subtype, Delta Radscore, and Radscore 1 in the prediction were clarified, providing a more detailed and intuitive basis for clinical decision-making. The nomogram illustrated the model prediction process, facilitating understanding and application by clinicians. CONCLUSIONS This study successfully constructed a model for predicting peripheral lymph node metastasis in thyroid cancer patients on the basis of enhanced CT radiomics combined with machine learning and improved the interpretability and clinical utility of the model through SHAP values and nomograms. The model not only improves the accuracy of predictions but also provides a more scientific and intuitive basis for clinical decision-making, with potential clinical application value.
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Affiliation(s)
- Wenzhi Wang
- Department of Cardiology, Radiology, and Surgery, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, 441000, China
| | - Feng Jin
- Department of Cardiology, Radiology, and Surgery, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, 441000, China
| | - Lina Song
- Department of Cardiology, Radiology, and Surgery, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, 441000, China
| | - Jinfang Yang
- Department of Cardiology, Radiology, and Surgery, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, 441000, China
- Department of Emergency, Oncology and Epidemiology, Xiangyang Key Laboratory of Maternal-Fetal Medicine on Fetal Congenital Heart Disease, Xiangyang No. 1 People'S Hospital, Hubei University of Medicine, Xiangyang, 441000, Hubei, People's Republic of China
| | - Yingjian Ye
- Department of Cardiology, Radiology, and Surgery, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, 441000, China
| | - Junjie Liu
- Department of Cardiology, Radiology, and Surgery, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, 441000, China
| | - Lei Xu
- Department of Cardiology, Radiology, and Surgery, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, 441000, China.
- Department of Emergency, Oncology and Epidemiology, Xiangyang Key Laboratory of Maternal-Fetal Medicine on Fetal Congenital Heart Disease, Xiangyang No. 1 People'S Hospital, Hubei University of Medicine, Xiangyang, 441000, Hubei, People's Republic of China.
| | - Peng An
- Department of Cardiology, Radiology, and Surgery, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, 441000, China.
- Department of Emergency, Oncology and Epidemiology, Xiangyang Key Laboratory of Maternal-Fetal Medicine on Fetal Congenital Heart Disease, Xiangyang No. 1 People'S Hospital, Hubei University of Medicine, Xiangyang, 441000, Hubei, People's Republic of China.
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Valizadeh P, Jannatdoust P, Ghadimi DJ, Bagherieh S, Hassankhani A, Amoukhteh M, Adli P, Gholamrezanezhad A. Predicting lymph node metastasis in thyroid cancer: systematic review and meta-analysis on the CT/MRI-based radiomics and deep learning models. Clin Imaging 2025; 119:110392. [PMID: 39742800 DOI: 10.1016/j.clinimag.2024.110392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2024] [Revised: 12/06/2024] [Accepted: 12/17/2024] [Indexed: 01/04/2025]
Abstract
BACKGROUND Thyroid cancer, a common endocrine malignancy, has seen increasing incidence, making lymph node metastasis (LNM) a critical factor for recurrence and survival. Radiomics and deep learning (DL) advancements offer the potential for improved LNM prediction using CT and MRI, though challenges in diagnostic accuracy remain. METHODS A systematic review and meta-analysis were conducted per established guidelines, with searches across PubMed, Scopus, Web of Science, and Embase up to February 15, 2024. Studies developing CT/MRI-based radiomics and/or DL models for preoperative LNM assessment in thyroid cancer patients were included. Data were extracted and analyzed using R software. RESULTS Sixteen studies were analyzed. In internal validation sets, sensitivity was 81.1 % (95 % CI: 75.6 %-85.6 %) and specificity 76.4 % (95 % CI: 68.4 %-82.9 %). Training sets showed a sensitivity of 84.4 % (95 % CI: 81.5 %-87 %) and a specificity of 84.7 % (95 % CI: 74.4 %-91.4 %). The pooled AUC was 86 % for internal validation and 87 % for training. Handcrafted radiomics had a sensitivity of 79.4 % and specificity of 69.2 %, while DL models showed 80.8 % sensitivity and 78.7 % specificity. Subgroup analysis revealed that models for papillary thyroid cancer (PTC) had a pooled specificity of 76.3 %, while those including other or unspecified cancers showed 68.3 % specificity. Despite heterogeneity, significant differences (p = 0.037) were noted between models with and without clinical data. CONCLUSION Radiomics and DL models show promising potential for detecting LNM in thyroid cancer, particularly in PTC. However, study heterogeneity underscores the need for further research to optimize these imaging tools.
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Affiliation(s)
- Parya Valizadeh
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Payam Jannatdoust
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Delaram J Ghadimi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sara Bagherieh
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Hassankhani
- Department of Radiology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA; Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Melika Amoukhteh
- Department of Radiology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA; Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Paniz Adli
- College of Letters and Science, University of California, Berkeley, CA, USA
| | - Ali Gholamrezanezhad
- Department of Radiology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA.
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Du J, He X, Fan R, Zhang Y, Liu H, Liu H, Liu S, Li S. Artificial intelligence-assisted precise preoperative prediction of lateral cervical lymph nodes metastasis in papillary thyroid carcinoma via a clinical-CT radiomic combined model. Int J Surg 2025; 111:2453-2466. [PMID: 39903541 DOI: 10.1097/js9.0000000000002267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Accepted: 12/19/2024] [Indexed: 02/06/2025]
Abstract
OBJECTIVES This study aimed to develop an artificial intelligence-assisted model for the preoperative prediction of lateral cervical lymph node metastasis (LCLNM) in papillary thyroid carcinoma (PTC) using computed tomography (CT) radiomics, providing a new noninvasive and accurate diagnostic tool for PTC patients with LCLNM. METHODS This retrospective study included 389 confirmed PTC patients, randomly divided into a training set ( n = 272) and an internal validation set ( n = 117), with an additional 40 patients from another hospital as an external validation set. Patient demographics were evaluated to establish a clinical model. Radiomic features were extracted from preoperative contrast-enhanced CT images (venous phase) for each patient. Feature selection was performed using analysis of variance and the least absolute shrinkage and selection operator algorithm. We employed support vector machine, random forest (RF), logistic regression, and XGBoost algorithms to build CT radiomic models for predicting LCLNM. A radiomics score (Rad-score) was calculated using a radiomic signature-based formula. A combined clinical-radiomic model was then developed. The performance of the combined model was evaluated using the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA). RESULTS A total of 1724 radiomic features were extracted from each patient's CT images, with 13 features selected based on nonzero coefficients related to LCLNM. Four clinically relevant factors (age, tumor location, thyroid capsule invasion, and central cervical lymph node metastasis) were significantly associated with LCLNM. Among the algorithms tested, the RF algorithm outperformed the others with five-fold cross-validation on the training set. After integrating the best algorithm with clinical factors, the areas under the ROC curves for the training, internal validation, and external validation sets were 0.910 (95% confidence interval [CI]: 0.729-0.851), 0.876 (95% CI: 0.747-0.911), and 0.821 (95% CI: 0.555-0.802), respectively, with DCA demonstrating the clinical utility of the combined radiomic model. CONCLUSIONS This study successfully established a clinical-CT radiomic combined model for predicting LCLNM, which may significantly enhance surgical decision-making for lateral cervical lymph node dissection in patients with PTC.
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Affiliation(s)
- Junze Du
- Department of Breast and Thyroid Surgery, Southwest Hospital, Army Medical University, Chongqing, China
| | - Xingyun He
- Department of Radiology, Southwest Hospital, Army Medical University, Chongqing, China
| | - Rui Fan
- Department of Radiology, Southwest Hospital, Army Medical University, Chongqing, China
| | - Yi Zhang
- Department of Breast and Thyroid Surgery, Southwest Hospital, Army Medical University, Chongqing, China
| | - Hao Liu
- Yizhun Medical AI, Beijing, China
| | - Haoxi Liu
- Department of Breast and Thyroid Surgery, Guiqian International General Hospital, Guiyang, China
| | - Shangqing Liu
- College of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Shichao Li
- Department of Breast and Thyroid Surgery, Southwest Hospital, Army Medical University, Chongqing, China
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He JL, Yan YZ, Zhang Y, Li JS, Wang F, You Y, Liu W, Hu Y, Wang MH, Pan QW, Liang Y, Ren MS, Wu ZW, You K, Zhang Y, Jiang J, Tang P. A machine learning model utilizing Delphian lymph node characteristics to predict contralateral central lymph node metastasis in papillary thyroid carcinoma: a prospective multicenter study. Int J Surg 2025; 111:360-370. [PMID: 39110573 PMCID: PMC11745755 DOI: 10.1097/js9.0000000000002020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 07/25/2024] [Indexed: 01/23/2025]
Abstract
BACKGROUND This study aimed to use artificial intelligence (AI) to integrate various radiological and clinical pathological data to identify effective predictors of contralateral central lymph node metastasis (CCLNM) in patients with papillary thyroid carcinoma (PTC) and to establish a clinically applicable model to guide the extent of surgery. METHODS This prospective cohort study included 603 patients with PTC from three centers. Clinical, pathological, and ultrasonographic data were collected and utilized to develop a machine learning (ML) model for predicting CCLNM. Model development at the internal center utilized logistic regression along with other ML algorithms. Diagnostic efficacy was compared among these methods, leading to the adoption of the final model (random forest). This model was subject to AI interpretation and externally validated at other centers. RESULTS CCLNM was associated with multiple pathological factors. The Delphian lymph node metastasis ratio, ipsilateral central lymph node metastasis number, and presence of ipsilateral central lymph node metastasis were independent risk factors for CCLNM. Following feature selection, a Delphian lymph node-CCLNM (D-CCLNM) model was established using the Random forest algorithm based on five attributes. The D-CCLNM model demonstrated the highest area under the curve (AUC; 0.9273) in the training cohort and exhibited high predictive accuracy, with AUCs of 0.8907 and 0.9247 in the external and validation cohorts, respectively. CONCLUSIONS The authors developed a new, effective method that uses ML to predict CCLNM in patients with PTC. This approach integrates data from Delphian lymph nodes and clinical characteristics, offering a foundation for guiding surgical decisions, and is conveniently applicable in clinical settings.
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Affiliation(s)
- Jia-ling He
- Department of Breast and Thyroid Surgery, Southwest Hospital, Army Medical University, Shapingba District
| | - Yu-zhao Yan
- Department of Breast and Thyroid Surgery, Southwest Hospital, Army Medical University, Shapingba District
| | - Yan Zhang
- Department of Otolaryngology-Head and Neck Surgery, Xinqiao Hospital, Army Medical University, Chongqing
| | - Jin-sui Li
- Department of Academician (expert) Workstation, Biological Targeting Laboratory of Breast Cancer, Breast and Thyroid Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan
| | - Fei Wang
- Department of Center for Medical Big Data and Artificial Intelligence, Southwest Hospital, Army Medical University, Shapingba District, Chongqing
| | - Yi You
- Department of Research Collaboration, R&D Center, Beijing Deepwise and League of PHD Technology Co., Ltd, Beijing
| | - Wei Liu
- Department of Breast and Thyroid Surgery, Southwest Hospital, Army Medical University, Shapingba District
| | - Ying Hu
- Department of Breast and Thyroid Surgery, Southwest Hospital, Army Medical University, Shapingba District
| | - Ming-Hao Wang
- Department of Breast and Thyroid Surgery, Southwest Hospital, Army Medical University, Shapingba District
| | - Qing-wen Pan
- Department of Breast and Thyroid Surgery, Southwest Hospital, Army Medical University, Shapingba District
| | - Yan Liang
- Department of Breast and Thyroid Surgery, Southwest Hospital, Army Medical University, Shapingba District
| | - Ming-shijing Ren
- Department of Breast and Thyroid Surgery, Southwest Hospital, Army Medical University, Shapingba District
| | - Zi-wei Wu
- Department of Breast and Thyroid Surgery, Southwest Hospital, Army Medical University, Shapingba District
| | - Kai You
- Department of Pharmacy of Jiangbei Campus, The 958th Hospital of Chinese People’s Liberation Army, Chongqing, People’s Republic of China
| | - Yi Zhang
- Department of Breast and Thyroid Surgery, Southwest Hospital, Army Medical University, Shapingba District
| | - Jun Jiang
- Department of Breast and Thyroid Surgery, Southwest Hospital, Army Medical University, Shapingba District
| | - Peng Tang
- Department of Breast and Thyroid Surgery, Southwest Hospital, Army Medical University, Shapingba District
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Zheng Y, Shi H, Fu S, Wang H, Li X, Li Z, Hai B, Zhang J. Development and validation of a radiomics-based nomogram for predicting pathological grade of upper urinary tract urothelial carcinoma. BMC Cancer 2024; 24:1546. [PMID: 39696125 DOI: 10.1186/s12885-024-13325-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 12/10/2024] [Indexed: 12/20/2024] Open
Abstract
BACKGROUND Upper urinary tract urothelial carcinoma (UTUC) is a rare and highly aggressive malignancy characterized by poor prognosis, making the accurate identification of high-grade (HG) UTUC essential for subsequent treatment strategies. This study aims to develop and validate a nomogram model using computed tomography urography (CTU) images to predict HG UTUC. METHODS A retrospective cohort study was conducted to include patients with UTUC who underwent radical nephroureterectomy and received a CTU examination prior to surgery. In the CTU images, tumor lesions located in the renal calyces, renal pelvis and ureter were segmented, and radiomics features from the unenhanced, medullary, and excretory phases were extracted. The maximum relevance minimum redundancy algorithm, least absolute shrinkage and selection operator, and various machine learning (ML) algorithms-including random forest, support vector machine, and eXtreme gradient boosting-were employed to select radiomics features and calculate radiomics scores. Logistic regression (LR) analysis was performed to identify the independent influencing factors of clinical baseline characteristics. Multiple datasets of radiomics features were constructed by integrating single-phase radiomics features with the most significant independent factor. Both LR and ML algorithms were utilized to develop predictive models. The area under the receiver operating characteristic curve (AUC values), accuracy, sensitivity, and specificity were assessed for model performance evaluation. Decision curve analysis was conducted to evaluate the clinical net benefits. RESULTS A total of 167 patients were enrolled in this study. Among them, 56 were diagnosed with low-grade UTUC (including papillary urothelial neoplasms with low malignant potential and low-grade urothelial carcinoma) as confirmed by postoperative pathological examination results, and 111 were of HG. These patients were randomly allocated to the training set and the validation set at a ratio of 7:3. The training set comprised 116 patients with a mean age of 63.5 ± 9.38 years and 38 males. The validation set comprised 51 patients with a mean age of 65.6 ± 11.1 years and 18 males. Hydronephrosis was identified as the most significant independent factor in the clinical baseline features. Models that include mixed-phase development achieve better performance compared to models that rely simply on single-phase development. The nomogram model had excellent predictive ability for HG UTUC, with AUC values of 0.844 and an accuracy of 0.793 in the validation sets. The nomogram model can enhance accuracy by 14.1% (79.3% vs. 65.2%) and sensitivity by 32.8% (93.2% vs. 60.4%) compared to urinary cytology. CONCLUSIONS This study developed a nomogram model, which significantly improved the diagnostic ability for HG UTUC compared to urinary cytology. Furthermore, the results of the decision curve analysis showed that the model had a net benefit and could provide a non-invasive and potentially diagnostic reference tool for HG UTUC.
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Affiliation(s)
- Yanghuang Zheng
- Department of Urology, The 2nd Affiliated Hospital of Kunming Medical University, No. 374 Dianmian Road, Kunming, Yunnan, 650101, People's Republic of China
- Department of Urology, The Second Hospital & Clinical Medical School, No. 82 Cui Ying Gate, Cheng Guan District, Lanzhou, Gansu, 730030, People's Republic of China
| | - Hongjin Shi
- Department of Urology, The 2nd Affiliated Hospital of Kunming Medical University, No. 374 Dianmian Road, Kunming, Yunnan, 650101, People's Republic of China
| | - Shi Fu
- Department of Urology, The 2nd Affiliated Hospital of Kunming Medical University, No. 374 Dianmian Road, Kunming, Yunnan, 650101, People's Republic of China
| | - Haifeng Wang
- Department of Urology, The 2nd Affiliated Hospital of Kunming Medical University, No. 374 Dianmian Road, Kunming, Yunnan, 650101, People's Republic of China
| | - Xin Li
- Department of Urology, The Cancer Hospital of Yunnan Province, No. 157 Jinbi Road, Kunming, Yunnan, 650118, People's Republic of China
| | - Zhi Li
- Department of Radiology, The First People's Hospital of Yunnan Province, No. 519 Kunzhou Road, Kunming, Yunnan, 650032, People's Republic of China
| | - Bing Hai
- Department of Respiratory Medicine, The 2nd Affiliated Hospital of Kunming Medical University, No. 374 Dianmian Road, Kunming, Yunnan, 650101, People's Republic of China.
| | - Jinsong Zhang
- Department of Urology, The 2nd Affiliated Hospital of Kunming Medical University, No. 374 Dianmian Road, Kunming, Yunnan, 650101, People's Republic of China.
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10
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Wang X, Zhang H, Fan H, Yang X, Fan J, Wu P, Ni Y, Hu S. Multimodal MRI Deep Learning for Predicting Central Lymph Node Metastasis in Papillary Thyroid Cancer. Cancers (Basel) 2024; 16:4042. [PMID: 39682228 DOI: 10.3390/cancers16234042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2024] [Revised: 11/26/2024] [Accepted: 11/28/2024] [Indexed: 12/18/2024] Open
Abstract
BACKGROUND Central lymph node metastasis (CLNM) in papillary thyroid cancer (PTC) significantly influences surgical decision-making strategies. OBJECTIVES This study aims to develop a predictive model for CLNM in PTC patients using magnetic resonance imaging (MRI) and clinicopathological data. METHODS By incorporating deep learning (DL) algorithms, the model seeks to address the challenges in diagnosing CLNM and reduce overtreatment. The results were compared with traditional machine learning (ML) models. In this retrospective study, preoperative MRI data from 105 PTC patients were divided into training and testing sets. A radiologist manually outlined the region of interest (ROI) on MRI images. Three classic ML algorithms (support vector machine [SVM], logistic regression [LR], and random forest [RF]) were employed across different data modalities. Additionally, an AMMCNet utilizing convolutional neural networks (CNNs) was proposed to develop DL models for CLNM. Predictive performance was evaluated using receiver operator characteristic (ROC) curve analysis, and clinical utility was assessed through decision curve analysis (DCA). RESULTS Lesion diameter was identified as an independent risk factor for CLNM. Among ML models, the RF-(T1WI + T2WI, T1WI + T2WI + Clinical) models achieved the highest area under the curve (AUC) at 0.863. The DL fusion model surpassed all ML fusion models with an AUC of 0.891. CONCLUSIONS A fusion model based on the AMMCNet architecture using MRI images and clinicopathological data was developed, effectively predicting CLNM in PTC patients.
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Affiliation(s)
- Xiuyu Wang
- Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging & Interventional Radiology, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing 210018, China
- Department of Radiology, Affiliated hospital of Jiangnan University, Wuxi 214121, China
| | - Heng Zhang
- Department of Radiology, Affiliated hospital of Jiangnan University, Wuxi 214121, China
| | - Hang Fan
- School of Artificial Intelligence and Computer Science, Jiangnan University, Wuxi 214121, China
| | - Xifeng Yang
- School of Artificial Intelligence and Computer Science, Jiangnan University, Wuxi 214121, China
| | - Jiansong Fan
- School of Artificial Intelligence and Computer Science, Jiangnan University, Wuxi 214121, China
| | - Puyeh Wu
- GE Healthcare, Beijing 100000, China
| | - Yicheng Ni
- Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging & Interventional Radiology, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing 210018, China
| | - Shudong Hu
- Department of Radiology, Affiliated hospital of Jiangnan University, Wuxi 214121, China
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11
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Lyu GW, Tong T, Yang GD, Zhao J, Xu ZF, Zheng N, Zhang ZF. Bibliometric and visual analysis of radiomics for evaluating lymph node status in oncology. Front Med (Lausanne) 2024; 11:1501652. [PMID: 39610679 PMCID: PMC11602298 DOI: 10.3389/fmed.2024.1501652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2024] [Accepted: 10/28/2024] [Indexed: 11/30/2024] Open
Abstract
Background Radiomics, which involves the conversion of digital images into high-dimensional data, has been used in oncological studies since 2012. We analyzed the publications that had been conducted on this subject using bibliometric and visual methods to expound the hotpots and future trends regarding radiomics in evaluating lymph node status in oncology. Methods Documents published between 2012 and 2023, updated to August 1, 2024, were searched using the Scopus database. VOSviewer, R Package, and Microsoft Excel were used for visualization. Results A total of 898 original articles and reviews written in English and be related to radiomics for evaluating lymph node status in oncology, published between 2015 and 2023, were retrieved. A significant increase in the number of publications was observed, with an annual growth rate of 100.77%. The publications predominantly originated from three countries, with China leading in the number of publications and citations. Fudan University was the most contributing affiliation, followed by Sun Yat-sen University and Southern Medical University, all of which were from China. Tian J. from the Chinese Academy of Sciences contributed the most within 5885 authors. In addition, Frontiers in Oncology had the most publications and transcended other journals in recent 4 years. Moreover, the keywords co-occurrence suggested that the interplay of "radiomics" and "lymph node metastasis," as well as "major clinical study" were the predominant topics, furthermore, the focused topics shifted from revealing the diagnosis of cancers to exploring the deep learning-based prediction of lymph node metastasis, suggesting the combination of artificial intelligence research would develop in the future. Conclusion The present bibliometric and visual analysis described an approximately continuous trend of increasing publications related to radiomics in evaluating lymph node status in oncology and revealed that it could serve as an efficient tool for personalized diagnosis and treatment guidance in clinical patients, and combined artificial intelligence should be further considered in the future.
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Affiliation(s)
- Gui-Wen Lyu
- Department of Radiology, The Third People's Hospital of Shenzhen, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - Tong Tong
- Department of Ultrasound, Shenzhen People’s Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, China
| | - Gen-Dong Yang
- Department of Radiology, The Third People's Hospital of Shenzhen, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - Jing Zhao
- Department of Radiology, The Third People's Hospital of Shenzhen, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - Zi-Fan Xu
- Department of Pathology, Shenzhen University Medical School, Shenzhen, China
| | - Na Zheng
- Department of Pathology, Shenzhen University Medical School, Shenzhen, China
| | - Zhi-Fang Zhang
- Department of Radiology, The Third People's Hospital of Shenzhen, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
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12
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Bourdillon AT. Computer Vision-Radiomics & Pathognomics. Otolaryngol Clin North Am 2024; 57:719-751. [PMID: 38910065 DOI: 10.1016/j.otc.2024.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
The role of computer vision in extracting radiographic (radiomics) and histopathologic (pathognomics) features is an extension of molecular biomarkers that have been foundational to our understanding across the spectrum of head and neck disorders. Especially within head and neck cancers, machine learning and deep learning applications have yielded advances in the characterization of tumor features, nodal features, and various outcomes. This review aims to overview the landscape of radiomic and pathognomic applications, informing future work to address gaps. Novel methodologies will be needed to potentially engineer ways of integrating multidimensional data inputs to examine disease features to guide prognosis comprehensively and ultimately clinical management.
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Affiliation(s)
- Alexandra T Bourdillon
- Department of Otolaryngology-Head & Neck Surgery, University of California-San Francisco, San Francisco, CA 94115, USA.
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13
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Murakami T, Shimizu H, Nojima H, Shuto K, Usui A, Kosugi C, Koda K. Diffusion-Weighted Magnetic Resonance Imaging for the Diagnosis of Lymph Node Metastasis in Patients with Biliary Tract Cancer. Cancers (Basel) 2024; 16:3143. [PMID: 39335116 PMCID: PMC11430223 DOI: 10.3390/cancers16183143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2024] [Revised: 09/03/2024] [Accepted: 09/07/2024] [Indexed: 09/30/2024] Open
Abstract
Objective: The diagnostic efficacy of the apparent diffusion coefficient (ADC) in diffusion-weighted magnetic resonance imaging (DW-MRI) for lymph node metastasis in biliary tract cancer was investigated in the present study. Methods: In total, 112 surgically resected lymph nodes from 35 biliary tract cancer patients were examined in this study. The mean and minimum ADC values of the lymph nodes as well as the long-axis and short-axis diameters of the lymph nodes were assessed by computed tomography (CT). The relationship between these parameters and the presence of histological lymph node metastasis was evaluated. Results: Histological lymph node metastasis was detected in 31 (27.7%) out of 112 lymph nodes. Metastatic lymph nodes had a significantly larger short-axis diameter compared with non-metastatic lymph nodes (p = 0.002), but the long-axis diameter was not significantly different between metastatic and non-metastatic lymph nodes. The mean and minimum ADC values for metastatic lymph nodes were significantly reduced compared with those for non-metastatic lymph nodes (p < 0.001 for both). However, the minimum ADC value showed the highest accuracy for the diagnosis of histological lymph node metastasis, with an area under the curve of 0.877, sensitivity of 87.1%, specificity of 82.7%, and accuracy of 83.9%. Conclusions: The minimum ADC value in DW-MRI is highly effective for the diagnosis of lymph node metastasis in biliary tract cancer. Accurate preoperative diagnosis of lymph node metastasis in biliary tract cancer should enable the establishment of more appropriate treatment strategies.
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Affiliation(s)
- Takashi Murakami
- Department of Surgery, Teikyo University Chiba Medical Center, Ichihara 299-0112, Japan
| | - Hiroaki Shimizu
- Department of Surgery, Teikyo University Chiba Medical Center, Ichihara 299-0112, Japan
| | - Hiroyuki Nojima
- Department of Surgery, Teikyo University Chiba Medical Center, Ichihara 299-0112, Japan
| | - Kiyohiko Shuto
- Department of Surgery, Teikyo University Chiba Medical Center, Ichihara 299-0112, Japan
| | - Akihiro Usui
- Department of Surgery, Teikyo University Chiba Medical Center, Ichihara 299-0112, Japan
| | - Chihiro Kosugi
- Department of Surgery, Teikyo University Chiba Medical Center, Ichihara 299-0112, Japan
| | - Keiji Koda
- Department of Surgery, Teikyo University Chiba Medical Center, Ichihara 299-0112, Japan
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14
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Pedersen MRV, Kusk MW, Lysdahlgaard S, Mork-Knudsen H, Malamateniou C, Jensen J. Nordic radiographers' and students' perspectives on artificial intelligence - A cross-sectional online survey. Radiography (Lond) 2024; 30:776-783. [PMID: 38461583 DOI: 10.1016/j.radi.2024.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 01/17/2024] [Accepted: 02/26/2024] [Indexed: 03/12/2024]
Abstract
INTRODUCTION The integration of artificial intelligence (AI) into the domain of radiography holds substantial potential in various aspects including workflow efficiency, image processing, patient positioning, and quality assurance. The successful implementation of AI within a Radiology department necessitates the participation of key stakeholders, particularly radiographers. The study aimed to provide a comprehensive investigation about Nordic radiographers' perspectives and attitudes towards AI in radiography. METHODS An online 29-item survey was distributed via social media platforms to Nordic students and radiographers working in Denmark, Norway, Sweden, Iceland, Greenland, and the Faroe Islands including items on demographics, specialization, educational background, place of work and perspectives and knowledge on AI. The items were a mix of closed-type and scaled questions, with the option for free-text responses when relevant. RESULTS The survey received responses from all Nordic countries with 586 respondents, 26.8% males, 72.1% females, and 1.1% non-binary/self-defined or preferred not to say. The mean age was 37.2 with a standard deviation (SD) of ±12.1 years, and the mean number of years since qualification was 14.2 SD ± 10.3 years. A total of 43% (n = 254) of the respondents had not received any AI training in clinical practice. Whereas 13% (n = 76) had received AI during radiography undergrad training. A total of 77.9% (n = 412) expressed interest in pursuing AI education. The majority of respondents were aware of the potential use of AI (n = 485, 82.8%) and 39.1% (n = 204) had no reservations about AI. CONCLUSION Overall, this study found that Nordic radiographers have a positive attitude toward AI. Very limited training or education has been provided to the radiographers. Especially since 82.8% reports on plans to implement AI in clinical practice. In general, awareness of AI applications is high, but the educational level is low for Nordic radiographers. IMPLICATION FOR PRACTICE This study emphasises the favourable view of AI held by students and Nordic radiographers. However, there is a need for continuous professional development to facilitate the implementation and effective utilization of AI tools within the field of radiography.
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Affiliation(s)
- M R V Pedersen
- Department of Radiology, Vejle Hospital - Part of Lillebaelt Hospital, Vejle, Denmark; Department of Radiology, Kolding Hospital- Part of Lillebaelt Hospital, Kolding, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark; Discipline of Medical Imaging & Radiation Therapy, School of Medicine, University College Cork, Ireland.
| | - M W Kusk
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark; Department of Radiology and Nuclear Medicine, University Hospital of Southern Denmark, Esbjerg, Denmark; IRIS - Imaging Research Initiative Southwest, University Hospital of Southern Denmark, Esbjerg, Denmark; Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland
| | - S Lysdahlgaard
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark; Department of Radiology and Nuclear Medicine, University Hospital of Southern Denmark, Esbjerg, Denmark; IRIS - Imaging Research Initiative Southwest, University Hospital of Southern Denmark, Esbjerg, Denmark
| | - H Mork-Knudsen
- Department of Radiology, Haukeland University Hospital, Norway
| | - C Malamateniou
- Department of Radiography, Division of Midwifery and Radiography, School of Health and Psychological Sciences, City, University of London, UK; European Federation of Radiographer Societies, Churchilllaan 11, 3527 GV, Utrecht, the Netherlands
| | - J Jensen
- Research and Innovation Unit of Radiology, University of Southern Denmark, Odense, Denmark; Department of Radiology, Odense University Hospital, Odense, Denmark
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15
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Xu ZY, Li ZZ, Cao LM, Zhong NN, Liu XH, Wang GR, Xiao Y, Liu B, Bu LL. Seizing the fate of lymph nodes in immunotherapy: To preserve or not? Cancer Lett 2024; 588:216740. [PMID: 38423247 DOI: 10.1016/j.canlet.2024.216740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 02/07/2024] [Accepted: 02/19/2024] [Indexed: 03/02/2024]
Abstract
Lymph node dissection has been a long-standing diagnostic and therapeutic strategy for metastatic cancers. However, questions over myriad related complications and survival outcomes are continuously debated. Immunotherapy, particularly neoadjuvant immunotherapy, has revolutionized the conventional paradigm of cancer treatment, yet has benefited only a fraction of patients. Emerging evidence has unveiled the role of lymph nodes as pivotal responders to immunotherapy, whose absence may contribute to drastic impairment in treatment efficacy, again posing challenges over excessive lymph node dissection. Hence, centering around this theme, we concentrate on the mechanisms of immune activation in lymph nodes and provide an overview of minimally invasive lymph node metastasis diagnosis, current best practices for activating lymph nodes, and the prognostic outcomes of omitting lymph node dissection. In particular, we discuss the potential for future comprehensive cancer treatment with effective activation of immunotherapy driven by lymph node preservation and highlight the challenges ahead to achieve this goal.
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Affiliation(s)
- Zhen-Yu Xu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
| | - Zi-Zhan Li
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
| | - Lei-Ming Cao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
| | - Nian-Nian Zhong
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
| | - Xuan-Hao Liu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
| | - Guang-Rui Wang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
| | - Yao Xiao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
| | - Bing Liu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China; Department of Oral & Maxillofacial - Head Neck Oncology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China.
| | - Lin-Lin Bu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China; Department of Oral & Maxillofacial - Head Neck Oncology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China.
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16
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Palomba G, Fernicola A, Corte MD, Capuano M, De Palma GD, Aprea G. Artificial intelligence in screening and diagnosis of surgical diseases: A narrative review. AIMS Public Health 2024; 11:557-576. [PMID: 39027395 PMCID: PMC11252578 DOI: 10.3934/publichealth.2024028] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/29/2024] [Accepted: 04/02/2024] [Indexed: 07/20/2024] Open
Abstract
Artificial intelligence (AI) is playing an increasing role in several fields of medicine. It is also gaining popularity among surgeons as a valuable screening and diagnostic tool for many conditions such as benign and malignant colorectal, gastric, thyroid, parathyroid, and breast disorders. In the literature, there is no review that groups together the various application domains of AI when it comes to the screening and diagnosis of main surgical diseases. The aim of this review is to describe the use of AI in these settings. We performed a literature review by searching PubMed, Web of Science, Scopus, and Embase for all studies investigating the role of AI in the surgical setting, published between January 01, 2000, and June 30, 2023. Our focus was on randomized controlled trials (RCTs), meta-analysis, systematic reviews, and observational studies, dealing with large cohorts of patients. We then gathered further relevant studies from the reference list of the selected publications. Based on the studies reviewed, it emerges that AI could strongly enhance the screening efficiency, clinical ability, and diagnostic accuracy for several surgical conditions. Some of the future advantages of this technology include implementing, speeding up, and improving the automaticity with which AI recognizes, differentiates, and classifies the various conditions.
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Affiliation(s)
- Giuseppe Palomba
- Department of Clinical Medicine and Surgery, University of Naples, “Federico II”, Sergio Pansini 5, 80131, Naples, Italy
| | - Agostino Fernicola
- Department of Clinical Medicine and Surgery, University of Naples, “Federico II”, Sergio Pansini 5, 80131, Naples, Italy
| | - Marcello Della Corte
- Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d'Aragona - OO. RR. Scuola Medica Salernitana, Salerno, Italy
| | - Marianna Capuano
- Department of Clinical Medicine and Surgery, University of Naples, “Federico II”, Sergio Pansini 5, 80131, Naples, Italy
| | - Giovanni Domenico De Palma
- Department of Clinical Medicine and Surgery, University of Naples, “Federico II”, Sergio Pansini 5, 80131, Naples, Italy
| | - Giovanni Aprea
- Department of Clinical Medicine and Surgery, University of Naples, “Federico II”, Sergio Pansini 5, 80131, Naples, Italy
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Zhong NN, Wang HQ, Huang XY, Li ZZ, Cao LM, Huo FY, Liu B, Bu LL. Enhancing head and neck tumor management with artificial intelligence: Integration and perspectives. Semin Cancer Biol 2023; 95:52-74. [PMID: 37473825 DOI: 10.1016/j.semcancer.2023.07.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 07/11/2023] [Accepted: 07/15/2023] [Indexed: 07/22/2023]
Abstract
Head and neck tumors (HNTs) constitute a multifaceted ensemble of pathologies that primarily involve regions such as the oral cavity, pharynx, and nasal cavity. The intricate anatomical structure of these regions poses considerable challenges to efficacious treatment strategies. Despite the availability of myriad treatment modalities, the overall therapeutic efficacy for HNTs continues to remain subdued. In recent years, the deployment of artificial intelligence (AI) in healthcare practices has garnered noteworthy attention. AI modalities, inclusive of machine learning (ML), neural networks (NNs), and deep learning (DL), when amalgamated into the holistic management of HNTs, promise to augment the precision, safety, and efficacy of treatment regimens. The integration of AI within HNT management is intricately intertwined with domains such as medical imaging, bioinformatics, and medical robotics. This article intends to scrutinize the cutting-edge advancements and prospective applications of AI in the realm of HNTs, elucidating AI's indispensable role in prevention, diagnosis, treatment, prognostication, research, and inter-sectoral integration. The overarching objective is to stimulate scholarly discourse and invigorate insights among medical practitioners and researchers to propel further exploration, thereby facilitating superior therapeutic alternatives for patients.
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Affiliation(s)
- Nian-Nian Zhong
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Han-Qi Wang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Xin-Yue Huang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Zi-Zhan Li
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Lei-Ming Cao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Fang-Yi Huo
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Bing Liu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China; Department of Oral & Maxillofacial - Head Neck Oncology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China.
| | - Lin-Lin Bu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China; Department of Oral & Maxillofacial - Head Neck Oncology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China.
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Nagendra L, Pappachan JM, Fernandez CJ. Artificial intelligence in the diagnosis of thyroid cancer: Recent advances and future directions. Artif Intell Cancer 2023; 4:1-10. [DOI: 10.35713/aic.v4.i1.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 07/24/2023] [Accepted: 08/07/2023] [Indexed: 09/07/2023] Open
Abstract
The diagnosis and management of thyroid cancer is fraught with challenges despite the advent of innovative diagnostic, surgical, and chemotherapeutic modalities. Challenges like inaccuracy in prognostication, uncertainty in cytopathological diagnosis, trouble in differentiating follicular neoplasms, intra-observer and inter-observer variability on ultrasound imaging preclude personalised treatment in thyroid cancer. Artificial intelligence (AI) is bringing a paradigm shift to the healthcare, powered by quick advancement of the analytic techniques. Several recent studies have shown remarkable progress in thyroid cancer diagnostics based on AI-assisted algorithms. Application of AI techniques in thyroid ultrasonography and cytopathology have shown remarkable impro-vement in sensitivity and specificity over the traditional diagnostic modalities. AI has also been explored in the development of treatment algorithms for indeterminate nodules and for prognostication in the patients with thyroid cancer. The benefits of high repeatability and straightforward implementation of AI in the management of thyroid cancer suggest that it holds promise for clinical application. Limited clinical experience and lack of prospective validation studies remain the biggest drawbacks. Developing verified and trustworthy algorithms after extensive testing and validation using prospective, multi-centre trials is crucial for the future use of AI in the pipeline of precision medicine in the management of thyroid cancer.
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Affiliation(s)
- Lakshmi Nagendra
- Department of Endocrinology, JSS Medical College & JSS Academy of Higher Education and Research Center, Mysore 570015, India
| | - Joseph M Pappachan
- Department of Endocrinology & Metabolism, Lancashire Teaching Hospitals NHS Trust, Preston PR2 9HT, United Kingdom
- Faculty of Science, Manchester Metropolitan University, Manchester M15 6BH, M15 6BH, United Kingdom
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, United Kingdom
| | - Cornelius James Fernandez
- Department of Endocrinology & Metabolism, Pilgrim Hospital, United Lincolnshire Hospitals NHS Trust, PE21 9QS PE21 9QS, United Kingdom
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