Evidence map›Paper›PMID 41070703›Full record

SynthesisThe Laryngoscope2026

Machine Learning to Predict Extranodal Extension in Head and Neck Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis.

Arshbir Aulakh, Masih Sarafan, Amardeep S Sekhon, Khanh Linh Tran, Ameen Amanian, Farahna Sabiq, Cornelius Kürten, Eitan Prisman

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in The Laryngoscope, 2026. 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. 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

8 authors.

Arshbir AulakhMD Undergraduate Program, Faculty of Medicine, University of British Columbia, Vancouver, Canada.ORCID 0009-0000-5476-1815
Masih SarafanMD Undergraduate Program, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
Amardeep S SekhonMD Undergraduate Program, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
Khanh Linh TranDivision of Otolaryngology-Head and Neck Surgery, Faculty of Medicine University of British Columbia, Vancouver, Canada.
Ameen AmanianDivision of Otolaryngology-Head and Neck Surgery, Faculty of Medicine University of British Columbia, Vancouver, Canada.
Farahna SabiqDepartment of Radiology, Faculty of Medicine University of British Columbia, Vancouver, Canada.
Cornelius KürtenDivision of Otolaryngology-Head and Neck Surgery, Faculty of Medicine University of British Columbia, Vancouver, Canada.
Eitan PrismanDivision of Otolaryngology-Head and Neck Surgery, Faculty of Medicine University of British Columbia, Vancouver, Canada.ORCID 0000-0001-7201-6181

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo 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

methodsTwo 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.

resultsOf 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.

conclusionMLAs demonstrate superior diagnostic performance in predicting ENE in HNSCC and may serve as a valuable adjunct to radiologists in clinical practice. LEVEL OF EVIDENCE: 1:

Indexed as

Extranodal ExtensionHead and Neck NeoplasmsMachine LearningSquamous Cell Carcinoma of Head and NeckTomography, X-Ray ComputedHumansLymphatic MetastasisENE predictionextranodal extensionhead and neck squamous cell carcinomamachine learning algorithmsradiologists

Identifiers

PMID41070703
PMCPMC12913757

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.