Predicting Nodal Metastases in Squamous Cell Carcinoma of the Oral Tongue Using Artificial Intelligence

Authors

Antoinette R. Esce, Department of Surgery, Division of Otolaryngology Head and Neck Surgery, 1 University of New Mexico, MSC10 5610, Albuquerque, NM, 87131, USA.Follow
Andrewe L. Baca, The University of New Mexico School of Medicine, 1 University of New Mexico, MSC08 4720, Albuquerque, NM 87131, USA.
Jordan P. Redemann, Department of Pathology, 1 University of New Mexico, MSC08 4640, Albuquerque, NM, 87131, USA.Follow
Ryan W. Rebbe, Department of Pathology, 1 University of New Mexico, MSC08 4640, Albuquerque, NM, 87131, USA.Follow
Fred Schultz, Department of Pathology, 1 University of New Mexico, MSC08 4640, Albuquerque, NM, 87131, USA.Follow
Shweta Agarwal, Department of Pathology, 1 University of New Mexico, MSC08 4640, Albuquerque, NM, 87131, USA.Follow
Joshua A. Hanson, Department of Pathology, 1 University of New Mexico, MSC08 4640, Albuquerque, NM, 87131, USA.Follow
Garth T. Olson, Department of Surgery, Division of Otolaryngology Head and Neck Surgery, 1 University of New Mexico, MSC10 5610, Albuquerque, NM, 87131, USA.Follow
David R. Martin, Department of Surgery, Division of Otolaryngology Head and Neck Surgery, 1 University of New Mexico, MSC10 5610, Albuquerque, NM, 87131, USA.Follow
Nathan H. Boyd, Department of Surgery, Division of Otolaryngology Head and Neck Surgery, 1 University of New Mexico, MSC10 5610, Albuquerque, NM, 87131, USA.Follow

Document Type

Article

Publication Date

11-5-2023

Abstract

OBJECTIVE: The presence of occult nodal metastases in patients with squamous cell carcinoma (SCC) of the oral tongue has implications for treatment. Upwards of 30% of patients will have occult nodal metastases, yet a significant number of patients undergo unnecessary neck dissection to confirm nodal status. This study sought to predict the presence of nodal metastases in patients with SCC of the oral tongue using a convolutional neural network (CNN) that analyzed visual histopathology from the primary tumor alone.

METHODS: Cases of SCC of the oral tongue were identified from the records of a single institution. Only patients with complete pathology data were included in the study. The primary tumors were randomized into 2 groups for training and testing, which was performed at 2 different levels of supervision. Board-certified pathologists annotated each slide. HALO-AI convolutional neural network and image software was used to perform training and testing. Receiver operator characteristic (ROC) curves and the Youden J statistic were used for primary analysis.

RESULTS: Eighty-nine cases of SCC of the oral tongue were included in the study. The best performing algorithm had a high level of supervision and a sensitivity of 65% and specificity of 86% when identifying nodal metastases. The area under the curve (AUC) of the ROC curve for this algorithm was 0.729.

CONCLUSION: A CNN can produce an algorithm that is able to predict nodal metastases in patients with squamous cell carcinoma of the oral tongue by analyzing the visual histopathology of the primary tumor alone.

Recommended Citation

Esce AR, Baca AL, Redemann JP, Rebbe RW, Schultz F, Agarwal S, Hanson JA, Olson GT, Martin DR, Boyd NH. Predicting nodal metastases in squamous cell carcinoma of the oral tongue using artificial intelligence. Am J Otolaryngol. 2024 Jan-Feb;45(1):104102. doi: 10.1016/j.amjoto.2023.104102. Epub 2023 Nov 5. PMID: 37948827.