Radiomics-Based Analysis in the Prediction of Occult Lymph Node Metastases in Patients with Oral Cancer: A Systematic Review

Abstract

Background: Tumor extension and metastatic cervical lymph nodes’ (LNs) number and dimensions are major prognostic factors in patients with oral squamous cell carcinoma (OSCC). Radiomics-based models are being integrated into clinical practice in the prediction of LN status prior to surgery in order to optimize the treatment, yet their value is still debated. Methods: A systematic review of the literature was conducted according to the PRISMA guideline. Baseline study characteristics, and methodological items were extracted and summarized. Results: A total of 10 retrospective studies were included into the present study, each of them exploiting a single imaging modality. Data from a cohort of 1489 patients were analyzed: the highest AUC value was 99.5%, ACC ranges from 68% to 97.5%, and sensibility and specificity were over 0.65 and 0.70, respectively. Conclusion: Radiomics may be a noninvasive tool to predict occult LN metastases (LNM) in OSCC patients prior to treatment; further prospective studies are warranted to create a reproducible and reliable method for the detection of LNM in OSCC.

Comparing the Diagnostic Accuracy of Ultrasonography, CT, MRI, and PET/CT in Cervical Lymph Node Metastasis of Oral Squamous Cell Carcinoma

“…Although not used in this study, MRI diffusion-weighted imaging and apparent diffusion coefficient may add new diagnostic criteria [42]. In recent years, research on diagnosing lymph nodes using artificial intelligence and radiomics has been reported, and this may be useful in diagnosing lymph node metastasis in the future [43,44].…”

Predicting nodal metastasis progression of oral tongue cancer using a hidden Markov model in MRI

“…Studies that apply negative palpation to define N0 neck may have a higher sensitivity than those that apply a more sophisticated assessment with prospective staging techniques. The method of MRI examination was adopted in this study ( 23 , 25 ).…”

“…Although there may be an increase risk in head and neck cancers when cervical lymph node disease is untreated, some reasons support withholding cervical lymph node treatment. A significant portion of patients experience a decrease in quality of life (shoulder dysfunction, for example) and needless medical expenses (22)(23)(24). Additionally, the cancer growth could be effected by this additional treatment.…”

“…Studies that apply negative palpation to define N0 neck may have a higher sensitivity than those that apply a more sophisticated assessment with prospective staging techniques. The method of MRI examination was adopted in this study (23,25). The risk of microscopic lymph node involvement not only changes over time in relation to the location of macroscopic metastases found with imaging but is also associated with the T stage.…”

A Radiomics Approach to Identify Immunologically Active Tumor in Patients with Head and Neck Squamous Cell Carcinomas

“…Over the past few years, we have observed an increasing trend of publications on radiomic approaches in oncology [11], especially for predicting diagnosis [12][13][14] and treatment response [15][16][17][18][19], as well as tumor molecular profiles [20,21]. In particular, in patients with HNSCC, different radiomic features extracted from computed tomography (CT) imaging, which is routinely performed in this setting, were significantly associated with clinical (local control, tumor failure, lymph node metastasis, extranodal extension, overall survival, human papillomavirus (HPV) status) and histological (differentiation grade, perineural and lymphovascular invasion) parameters as well as molecular features, especially some specific somatic mutations, in patients with head and neck cancer [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39].…”