Evidence map›Paper›PMID 40647478›Full record

ArticleCancers2025

Exploring the Potential of a Deep Learning Model for Early CT Detection of High-Grade Metastatic Epidural Spinal Cord Compression and Its Impact on Treatment Delays.

James Thomas Patrick Decourcy Hallinan, Junran Wu, Changshuo Liu, Hien Anh Tran, Noah Tian Run Lim, Andrew Makmur, Wilson Ong, Shilin Wang, Ee Chin Teo, Yiong Huak Chan and 8 more

Abstract read
In one paragraph

Article in Cancers, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. Diagnostic errors in spinal metastases: a systematic review of contributing clinical and systemic factors.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
    Review
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

18 authors.

James Thomas Patrick Decourcy HallinanDepartment of Diagnostic Imaging, National University Hospital, National University Health System, Singapore 119074, Singapore.ORCID 0000-0002-0082-9033
Junran WuDepartment of Computer Science, School of Computing, National University of Singapore, Singapore 117417, Singapore.
Changshuo LiuDepartment of Computer Science, School of Computing, National University of Singapore, Singapore 117417, Singapore.
Hien Anh TranLee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore.ORCID 0009-0002-9887-1463
Noah Tian Run LimLee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore.
Andrew MakmurDepartment of Diagnostic Imaging, National University Hospital, National University Health System, Singapore 119074, Singapore.ORCID 0000-0002-9631-4121
Wilson OngDepartment of Diagnostic Imaging, National University Hospital, National University Health System, Singapore 119074, Singapore.ORCID 0000-0003-0262-3802
Shilin WangDepartment of Orthopaedic Surgery, National University Hospital, National University Health System, Singapore 119074, Singapore.
Ee Chin TeoDepartment of Diagnostic Imaging, National University Hospital, National University Health System, Singapore 119074, Singapore.ORCID 0000-0002-7053-2083
Yiong Huak ChanBiostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore.ORCID 0000-0002-5076-5269
Hwee Weng Dennis HeyDepartment of Orthopaedic Surgery, National University Hospital, National University Health System, Singapore 119074, Singapore.ORCID 0000-0002-2012-9835
Leok-Lim LauDepartment of Orthopaedic Surgery, National University Hospital, National University Health System, Singapore 119074, Singapore.ORCID 0000-0003-3512-2844
Joseph ThambiahDepartment of Orthopaedic Surgery, National University Hospital, National University Health System, Singapore 119074, Singapore.
Hee-Kit WongDepartment of Orthopaedic Surgery, National University Hospital, National University Health System, Singapore 119074, Singapore.ORCID 0000-0003-1176-1238
Gabriel LiuDepartment of Orthopaedic Surgery, National University Hospital, National University Health System, Singapore 119074, Singapore.
Naresh KumarDepartment of Orthopaedic Surgery, National University Hospital, National University Health System, Singapore 119074, Singapore.ORCID 0000-0003-4538-5031
Beng Chin OoiDepartment of Computer Science, School of Computing, National University of Singapore, Singapore 117417, Singapore.
Jiong Hao Jonathan TanDepartment of Orthopaedic Surgery, National University Hospital, National University Health System, Singapore 119074, Singapore.

Funding

National Medical Research Council CIAINV23jan-0001, MOH-001405; CNIG20nov-0011, MOH-000725
6 · The paper itself

Abstract

backgroundDelay in diagnosing metastatic epidural spinal cord compression (MESCC) adversely impacts clinical outcomes. High-grade MESCC is frequently overlooked on routine staging CT scans. We aim to assess the potential of our deep learning model (DLM) in detecting high-grade MESCC and reducing diagnostic delays.

methodsThis retrospective review analyzed 140 patients with surgically treated MESCC between C7 and L2 during 2015-2022. An experienced radiologist (serving as the reference standard), a consultant spine surgeon, and the DLM independently classified staging CT scans into high-grade MESCC or not. The findings were compared to original radiologist (OR) reports; inter-rater agreement was assessed. Diagnostic delay referred to the number of days elapsed from CT to diagnostic MRI scan.

resultsOverall, 95/140 (67.8%) patients had preoperative CT scans. High-grade MESCC was identified in 84/95 (88.4%) of the scans by the radiologist (reference standard), but in only 32/95 (33.7%) of the preoperative scans reported by the OR. There was almost perfect agreement between the radiologist and the surgeon (kappa = 0.947, 95% CI = 0.893-1.000) (

conclusionsThe original radiologist reports frequently missed high-grade MESCC in staging CT. Our DLM for CT diagnosis of high-grade MESCC showed almost perfect inter-rater agreement with two experienced reviewers. This study is the first to demonstrate that the DLM could help reduce diagnostic delays. Further prospective research is required to understand its precise role in improving the early diagnosis/treatment of MESCC.

Indexed as

Bilsky grading scalecomputed tomographymetastatic epidural spinal cord compressionspinal metastasestreatment delays

Identifiers

PMID40647478
PMCPMC12248473

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Registered trials

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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.