Artificial Intelligence Empowered Surgeons: A novel machine learning model to determine surgical resectability in squamous cell carcinoma of the buccal mucosa.
Affiliation:
1. All India Institute of Medical Sciences, Patna
Abstract
Abstract
Purpose Indian patients with squamous cell carcinoma of the buccal mucosa tend to present with advanced-stage disease, which is linked to poor prognosis. The treatment is primarily surgical but the current staging system, lacks specificity in accurately categorizing surgical candidates. This study aims to develop an innovative deep learning model to analyse imaging data from Contrast Enhanced Computed Tomography (CECT) to predict whether the patient may benefit from surgery upfront or need neoadjuvant chemotherapy for tumour downsizing prior to surgery, since T4b tumours may be technically unresectable (borderline resectable) and may render positive margins on upfront surgery.Methods This prospective observational pilot study, from April 2022 - March 2024 curated a dataset of 256 preoperative CECT scans of patients with T4a and T4b Squamous cell Carcinomas (SCC) of the buccal mucosa, which were integrated into a novel artificial intelligence-based machine learning model designed to predict resectability for upfront surgery. A Convolutional Neural Network (CNN) based predictive model has been developed to distinguish between "Borderline Resectable" and "Resectable Upfront" disease.Results The model displayed high performance with an overall F1 score of 0.8, efficiently stratifying tumors based on resectability. The AUC for the training set was 0.9652, with 50.39% sensitivity, 96.65% specificity, 65.75% negative predictive value, and 94.20% positive predictive value. The validation set had an AUC of 0.9735, along with 98.40% Specificity, 67.96% Negative Predictive Value, 55.73% Sensitivity, and 97.33% Positive Predictive Value.Conclusion This study represents the first step toward the use of artificial intelligence-based machine learning model to aid in the treatment stratification of patients with squamous cell carcinoma buccal mucosa, thus avoiding the possibility of margin positive resection with upfront surgery.
Publisher
Springer Science and Business Media LLC
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