Assessing the value of artificial intelligence-based image analysis for pre-operative surgical planning of neck dissections and iENE detection in head and neck cancer patients.
Journal:
Discover oncology
Published Date:
May 30, 2025
Abstract
OBJECTIVES: Accurate preoperative detection and analysis of lymph node metastasis (LNM) in head and neck squamous cell carcinoma (HNSCC) is essential for the surgical planning and execution of a neck dissection and may directly affect the morbidity and prognosis of patients. Additionally, predicting extranodal extension (ENE) using pre-operative imaging could be particularly valuable in oropharyngeal HPV-positive squamous cell carcinoma, enabling more accurate patient counseling, allowing the decision to favor primary chemoradiotherapy over immediate neck dissection when appropriate. Currently, radiological images are evaluated by radiologists and head and neck oncologists; and automated image interpretation is not part of the current standard of care. Therefore, the value of preoperative image recognition by artificial intelligence (AI) with the large language model (LLM) ChatGPT-4 V was evaluated in this exploratory study based on neck computed tomography (CT) images of HNSCC patients with cervical LNM, and corresponding images without LNM. The objective of this study was to firstly assess the preoperative rater accuracy by comparing clinician assessments of imaging-detected extranodal extension (iENE) and the extent of neck dissection to AI predictions, and secondly to evaluate the pathology-based accuracy by comparing AI predictions to final histopathological outcomes.
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