Evidence map›Paper›PMID 39078472›Full record

ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2024

The Neck-Persistency-Net: a three-dimensional, convolution, deep neural network aids in distinguishing vital from non-vital persistent cervical lymph nodes in advanced head and neck squamous cell carcinoma after primary concurrent radiochemotherapy.

Matthias Santer, Philipp Zelger, Joachim Schmutzhard, Wolfgang Freysinger, Annette Runge, Timo Maria Gottfried, Andrea Tröger, Samuel Vorbach, Julian Mangesius, Gerlig Widmann and 3 more

Abstract read
In one paragraph

Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Matthias SanterDepartment of Otorhinolaryngology-Head and Neck Surgery, Medical University of Innsbruck, 6020, Innsbruck, Austria.
Philipp ZelgerDepartment for Hearing, Voice and Speech Disorders, Medical University of Innsbruck, 6020, Innsbruck, Austria. philipp.zelger@i-med.ac.at.ORCID http://orcid.org/0000-0002-6543-7620
Joachim SchmutzhardDepartment of Otorhinolaryngology-Head and Neck Surgery, Medical University of Innsbruck, 6020, Innsbruck, Austria.
Wolfgang FreysingerDepartment of Otorhinolaryngology-Head and Neck Surgery, Medical University of Innsbruck, 6020, Innsbruck, Austria.
Annette RungeDepartment of Otorhinolaryngology-Head and Neck Surgery, Medical University of Innsbruck, 6020, Innsbruck, Austria.
Timo Maria GottfriedDepartment of Otorhinolaryngology-Head and Neck Surgery, Medical University of Innsbruck, 6020, Innsbruck, Austria.
Andrea TrögerDepartment of Otorhinolaryngology-Head and Neck Surgery, Medical University of Innsbruck, 6020, Innsbruck, Austria.
Samuel VorbachDepartment of Radiation-Oncology, Medical University of Innsbruck, 6020, Innsbruck, Austria.
Julian MangesiusDepartment of Radiation-Oncology, Medical University of Innsbruck, 6020, Innsbruck, Austria.
Gerlig WidmannDepartment of Radiology, Medical University of Innsbruck, 6020, Innsbruck, Austria.
Simone GrafDepartment for Hearing, Voice and Speech Disorders, Medical University of Innsbruck, 6020, Innsbruck, Austria.
Benedikt Gabriel HofauerDepartment of Otorhinolaryngology-Head and Neck Surgery, Medical University of Innsbruck, 6020, Innsbruck, Austria.
Daniel DejacoDepartment of Otorhinolaryngology-Head and Neck Surgery, Medical University of Innsbruck, 6020, Innsbruck, Austria.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo evaluate the diagnostic performance (DP) of the high-resolution contrast computed tomography (HR-contrast-CT) based Neck-Persistency-Net in distinguishing vital from non-vital persistent cervical lymph nodes (pcLNs) in patients with advanced head and neck squamous cell carcinoma (HNSCC) following primary concurrent chemoradiotherapy (CRT) with [18F]-fluorodeoxyglucose positron emission tomography and high-resolution contrast-enhanced computed tomography ([18F]FDG-PET-CT). Furthermore, the Neck-Persistency-Net's potential to justify omitting post-CRT neck dissection (ND) without risking treatment delays or preventing unnecessary surgery was explored.

methodsAll HNSCC patients undergoing primary CRT followed by post-CRT-ND for pcLNs recorded in the institutional HNSCC registry were analyzed. The Neck-Persistency-Net DP was explored for three scenarios: balanced performance (BalPerf), optimized sensitivity (OptSens), and optimized specificity (OptSpec). Histopathology of post-CRT-ND served as a reference.

resultsAmong 68 included patients, 11 were female and 32 had vital pcLNs. The Neck-Persistency-Net demonstrated good DP with an area under the curve of 0.82. For BalPerf, both sensitivity and specificity were 78%; for OptSens (90%), specificity was 62%; for OptSpec (95%), sensitivity was 54%. Limiting post-CRT-ND to negative results would have delayed treatment in 27%, 40%, and 7% for BalPerf, OptSens and OptSpec, respectively, versus 23% for [18F]FDG-PET-CT. Conversely, restricting post-CRT-ND to positive results would have prevented unnecessary post-CRT-ND in 78%, 60%, and 95% for BalPerf, OptSens and OptSpec, respectively, versus 55% for [18F]FDG-PET-CT.

conclusionThe DP of the Neck-Persistency-Net was comparable to [18F]-FDG-PET-CT. Depending on the chosen decision boundary, the potential to justify the omission of post-CRT-ND without risking treatment delays in false negative findings or reliably prevent unnecessary surgery in false positive findings outperforms the [18F]-FDG-PET-CT.

Indexed as

ChemoradiotherapyHead and Neck NeoplasmsLymphatic MetastasisLymph NodesPositron Emission Tomography Computed TomographySquamous Cell Carcinoma of Head and NeckAdultAgedDeep LearningFemaleFluorodeoxyglucose F18HumansImaging, Three-DimensionalMaleMiddle AgedNeckFluorodeoxyglucose F18RadiopharmaceuticalsArtificial intelligenceHNSCCMachine learningPET/CTRadiomicsSalvage surgery

Identifiers

PMID39078472
PMCPMC11512899

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.