Evidence map›Paper›PMID 42618635›Full record

ArticleNature medicine2026

Large-scale AI-guided liver malignancy diagnosis: multicenter study and a single-arm trial.

Xiaoming Zhang, Chunli Li, Xu Han, Xiaoli Yin, Chaoya Zhang, Jian Zhou, Kai Cao, Qi Liu, Yang Hong, Yingshan Gao and 18 more

Registry-linked trialAbstract read
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In one paragraph

Article in Nature medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07153783 (AI-human Collaborative Diagnosis of Liver Tumors Using CE-CT), which is not on this 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.

NCT07153783 nacompletednot on this map

AI-human Collaborative Diagnosis of Liver Tumors Using CE-CT

TypeinterventionalSponsorShengjing HospitalRan2025 to 2025Enrolled10,333ConditionsHepatocellular Carcinoma (HCC), Intrahepatic Cholangiocarcinoma (Icc), Hepatic Metastasis, Hepatic HemangiomaArmsAI-human collaboration for CE-CTs diagnosis
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. 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

28 authors.

Xiaoming Zhang *Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China.ORCID http://orcid.org/0009-0000-3986-885X
Chunli Li *Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China.ORCID http://orcid.org/0000-0002-7220-3523
Xu Han *Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Xiaoli Yin *Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China.
Chaoya Zhang *Department of Radiology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Jian Zhou *State Key Laboratory of Oncology in South China, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangdong Provincial Clinical Research Center for Cancer, Department of Radiology, Sun Yat-sen University Cancer Center, Guangzhou, China.ORCID http://orcid.org/0000-0002-6868-9866
Kai Cao *Department of Radiology, Shanghai Institution of Pancreatic Disease, Shanghai, China.
Qi Liu *Department of Radiology, The Second Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, China.
Yang Hong *Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China.ORCID http://orcid.org/0009-0003-9444-877X
Yingshan Gao *Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China.
Beilei CuiDepartment of Electrical Engineering, The Chinese University of Hong Kong, Hong Kong, China.ORCID http://orcid.org/0009-0009-7900-8032
Qianqian ZhangDepartment of Radiology, Yantai Yuhuangding Hospital, Yantai, China.
Jianyi QiaoDepartment of Radiology, Shengjing Hospital of China Medical University, Shenyang, China.
Ming SunDepartment of Radiology, Shengjing Hospital of China Medical University, Shenyang, China.
Wei LiuDAMO Academy, Alibaba Group, Hangzhou, China.
Yuan GaoDAMO Academy, Alibaba Group, Hangzhou, China.
Shiling ZhongDepartment of Radiology, Chengdu Sixth People's Hospital, Chengdu, China.
Ruobing BaiDepartment of Radiology, Shengjing Hospital of China Medical University, Shenyang, China.ORCID http://orcid.org/0009-0009-6312-9809
Tianan JiangDepartment of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.ORCID http://orcid.org/0000-0002-7672-8394
Olivier HumbertUniversité Côte D'Azur, INSERM, CNRS, iBV, Nice, France.
Sébastien OurselinSchool of Biomedical Engineering & Imaging Sciences, King's College London, London, UK. sebastien.ourselin@kcl.ac.uk.ORCID http://orcid.org/0000-0002-5694-5340
Maria A ZuluagaEURECOM, Sophia Antipolis, France. maria.zuluaga@eurecom.fr.ORCID http://orcid.org/0000-0002-1147-766X
Ke YanDAMO Academy, Alibaba Group, Hangzhou, China. yanke.yan@alibaba-inc.com.ORCID http://orcid.org/0000-0002-0034-9013
Qi ZhangDepartment of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China. qi.zhang@zju.edu.cn.
Yang HouDepartment of Radiology, Shengjing Hospital of China Medical University, Shenyang, China. houy2@sj-hospital.org.ORCID http://orcid.org/0000-0002-9184-5441
Tingbo LiangDepartment of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China. liangtingbo@zju.edu.cn.ORCID http://orcid.org/0000-0003-0143-3353
Ling ZhangDAMO Academy, Alibaba Group, Washington DC, USA. ling.z@alibaba-inc.com.ORCID http://orcid.org/0000-0001-8371-5252
Yu ShiDepartment of Radiology, Shengjing Hospital of China Medical University, Shenyang, China. 18940259980@163.com.ORCID http://orcid.org/0000-0003-1940-0074

Funding

National Natural Science Foundation of China (National Science Foundation of China) 82471971National Natural Science Foundation of China (National Science Foundation of China) 82473461
6 · The paper itself

Abstract

Liver malignancies are frequently evaluated on contrast-enhanced computed tomography (CE-CT), but missed or delayed diagnoses remain a clinically important challenge in high-volume, real-world radiology workflows, highlighting the need for scalable diagnostic safety net approaches. To address this, we developed the Liver DiagnOsis Network (LiON), a CE-CT-based artificial intelligence (AI) system that supports flexible multiphase processing, clinical data integration and workflow-compatible liver malignancy diagnosis. LiON was trained on 6,443 patients and retrospectively validated across 22,251 patients from multicenter and real-world cohorts. LiON achieved high performance for malignancy diagnosis, with an area under the receiver operating characteristic curve (AUC) of 0.975 (95% confidence interval (CI): 0.971-0.979), and maintained robust performance in real-world cohorts and among patients with hepatic steatosis (AUC 0.971, 95% CI: 0.952-0.985) and cirrhosis (AUC 0.924, 95% CI: 0.901-0.946). We then conducted a single-arm trial in 10,333 patients in routine clinical practice, in which LiON functioned as an additional AI reader within the existing clinical workflow. The trial met its primary endpoint, defined as an AUC for malignancy diagnosis with the lower bound of the 95% CI exceeding 0.900, achieving an AUC of 0.952 (95% CI: 0.942-0.961). Secondary outcomes demonstrated that AI-human collaboration identified 51 previously overlooked lesions (15 malignancies) and triggered 37 amended radiology reports, 22 multidisciplinary team escalations and clinical management changes in a subset of patients. These findings suggest that AI, when deployed as a workflow-compatible diagnostic support, may help reduce missed or delayed diagnoses and guide clinical interventions. Nevertheless, further evidence from prospective comparative studies across diverse healthcare systems is warranted to assess effects on clinical outcomes. ClinicalTrials.gov identifier: NCT07153783 .

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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.