AI-enhanced CT reshapes head and neck cancer risk stratification

RadAI Slice Newsletter

Weekly Updates in Radiology AI

Good morning, there. AI-driven CT analysis of lymph node ENE improved risk prediction in 1,733 head and neck cancer patients.

I was struck by how this multicenter study shows real-world AI utility for complex, high-impact cancer decisions. Incorporating automated extranodal extension quantification improved risk stratification and survival prediction, showing clear added value over current staging. This feels like a practical leap where imaging AI reshapes how radiologists contribute to clinical decision-making and multidisciplinary care.

How ready are you to add AI-derived risk metrics to your cancer reports?

Here's what you need to know about Radiology AI last week:

• AI boosts head and neck cancer CT risk prediction in multicenter study

• LLMs flag high-priority radiology reports with strong test accuracy

• Multimodal ML improves 5-year mortality prediction after PCI

• Automated radiomics, text, and image fusion improves ESCC chemoimmunotherapy response prediction

• Plus: 1 newly released dataset, 3 FDA approved devices & 4 new papers.

🔬 AI boosts head and neck cancer CT risk prediction in multicenter study

RadAI Slice: AI-based ENE detection on CT improved survival risk models in oropharyngeal carcinoma.

The details:

• Multicenter study of 1,733 patients across three institutions

• Automated lymph node ENE via deep learning from CT scans

• Independent association with distant control (HR 1.44) and overall survival (HR 1.30)

• AI-ENE improved risk grouping C-indices over traditional staging

• Larger benefits observed in HPV-negative patients

Key takeaway: This large, externally validated AI tool moves complex lymph node interpretation from pathology to pre-treatment imaging, enabling more personalized, accurate risk stratification and possibly altering radiation and surgical planning workflows.

📋 LLMs flag high-priority radiology reports with strong test accuracy

RadAI Slice: Fine-tuned LLMs accurately detected urgent findings in radiology reports from routine practice.

The details:

• Tested on 176 reports with balanced critical vs non-critical cases

• Best LLM achieved ROCAUC 0.968, PRAUC 0.962, F1=0.916

• Inputs used: radiology findings and referring department

• No extra benefit adding pre-exam diagnosis

• Could support faster communication of urgent results

Key takeaway: Deploying LLMs to identify actionable findings may optimize radiologist workflow, reduce error risk, and speed up escalation of care—especially as imaging volumes and reporting demands increase.

🧬 Multimodal ML improves 5-year mortality prediction after PCI

RadAI Slice: A large-scale, real-world study shows patient outcomes are better predicted by models integrating imaging, text, and EMR data.

The details:

• 10,353 patient cohort, 5-year all-cause mortality endpoint

• Model uses CT angiography video, procedural text (BioBERT), and EMR fields

• Trimodal AUC-ROC: 0.814, superior to single-source models

• Explains predictions with SHAP for greater transparency

Key takeaway: Multimodal ML leveraging CT images, reports, and structured data is practical in large cohorts and may advance individualized cardiac risk models beyond traditional scores.

🩸 Automated radiomics, text, and image fusion improves ESCC chemoimmunotherapy response prediction

RadAI Slice: A validated AI fusion of CT and pathology slides offers accurate, transparent pCR prediction for ESCC patients pre-surgery.

The details:

• Three-center, 335-patient cohort for neoadjuvant chemoimmunotherapy

• Model fuses CT radiomics and H&E 'pathomics' features

• AUC 0.97 in training, 0.78–0.76 in holdout and external test sets

• Model explains reasoning both per-case and cohort-wide

Key takeaway: This clinically relevant, interpretable model supports decision-making about surgery vs further surveillance in ESCC, showing the rising role of multimodal, explainable AI in oncologic radiology.

Pixel-Level Tear Meniscus Segmentation Dataset (TMH-MM) (2025-12-11)

Modality: Ocular Imaging (Color, Infrared) | Focus: Lower eyelid, Tear meniscus | Task: Segmentation, Quantification

• Size: 1,693 color + 1,739 infrared images; healthy patients; 5 Chinese centers

• Annotations: Pixel-level masks for tear meniscus and central pupillary area; reviewed by experts

• Institutions: Wenzhou Medical University, Zhejiang Normal University, et al.

• Availability:

  Public (link)

• Highlight: First multicenter, multimodal, expert-verified, pixel-level dataset for tear meniscus segmentation in dry eye.

🏛️ FDA Clearances

• K253489 - Hyperfine Swoop Portable MRI receives 510(k) clearance as a point-of-care MR imaging solution—supporting rapid bedside neuroimaging in diverse practice settings.

• K251883 - MIM LesionID Pro receives FDA 510(k) clearance, supporting multi-modality lesion tracking and segmentation for radiology workflow efficiency.

• K252294 - Fetal EchoScan (v1.2) cleared as a CADe solution, analyzing medical images to help detect lesions suspicious for cancer.

• Explore last week's 5 radiology AI FDA approvals.

📄 Fresh Papers

• doi:10.1016/j.jacr.2025.12.024 - GPT-4o offered automated, helpful feedback on 5,000 radiology resident breast imaging reports, aligning closely with attending radiologist consensus.

• doi:10.1093/bjr/tqaf309 - Meta-analysis of 14 models shows AI detects pneumoperitoneum on radiography with 83.6% sensitivity and 92.9% specificity, aiding emergency diagnosis.

• doi:10.1038/s41598-025-31967-2 - A federated learning AI combining RegNetZ and Swin-Transformer achieves 99% AUC for pancreatic cancer detection across multiple institutions and modalities.

• doi:10.64898/2025.12.21.25342791 - A deep learning framework using multimodal MRI predicted motor decline and subtypes in 268 Parkinson’s patients, outperforming previous models.

• Browse 148 new radiology AI studies from last week.

📰 Everything else in Radiology AI last week

• AI-enhanced low-dose breast MRI retained diagnostic sensitivity and accuracy while reducing gadolinium by 75% in a small prospective study.

• NVIDIA projects a shift toward autonomous radiology with AI agents, but industry leaders note workflow and ethical challenges persist.

• Experts debate if AI could or should replace clinicians, spotlighting ethics, burnout, misdiagnosis risk, and evolving regulatory response.

• Read 6 fresh radiology AI news articles for last week.

That's it for today!

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