Journal Article

Diagnostic performance of artificial intelligence in detecting oral potentially malignant disorders and oral cancer using medical diagnostic imaging: a systematic review and meta-analysis

Sahoo, Krushna Chandra, Dash, Girish Chandra, Panda, Bhuputra, Baliarsingh, Santos Kumar, Kumar, Gunjan, Sahoo, Rakesh Kumar, Pati, Sanghamitra

2024

Overview

Oral cancer is a widespread global health problem characterised by high mortality rates, wherein early detection is critical for better survival outcomes and quality of life. While visual examination is the primary method for detecting oral cancer, it may not be practical in remote areas. AI algorithms have shown some promise in detecting cancer from medical images, but their effectiveness in oral cancer detection remains Naïve. This systematic review aims to provide an extensive assessment of the existing evidence about the diagnostic accuracy of AI-driven approaches for detecting oral potentially malignant disorders (OPMDs) and oral cancer using medical diagnostic imaging. Adhering to PRISMA guidelines, the review scrutinised literature from PubMed, Scopus, and IEEE databases, with a specific focus on evaluating the performance of AI architectures across diverse imaging modalities for the detection of these conditions. The performance of AI models, measured by sensitivity and specificity, was assessed using a hierarchical summary receiver operating characteristic (SROC) curve, with heterogeneity quantified through I statistic. To account for inter-study variability, a random effects model was utilized. We screened 296 articles, included 55 studies for qualitative synthesis, and selected 18 studies for meta-analysis. Studies evaluating the diagnostic efficacy of AI-based methods reveal a high sensitivity of 0.87 and specificity of 0.81. The diagnostic odds ratio (DOR) of 131.63 indicates a high likelihood of accurate diagnosis of oral cancer and OPMDs. The SROC curve (AUC) of 0.9758 indicates the exceptional diagnostic performance of such models. The research showed that deep learning (DL) architectures, especially CNNs (convolutional neural networks), were the best at finding OPMDs and oral cancer. Histopathological images exhibited the greatest sensitivity and specificity in these detections. These findings suggest that AI algorithms have the potential to function as reliable tools for the early diagnosis of OPMDs and oral cancer, offering significant advantages, particularly in resource-constrained settings. https://www.crd.york.ac.uk/, PROSPERO (CRD42023476706).

• Publisher: Frontiers Media SA,Frontiers Media S.A
• Subject: Accuracy / AI algorithms / Algorithms / Artificial intelligence / Decision making / Deep learning / diagnostic performance / early detection / Machine learning / Mammography / Medical diagnosis / medical diagnostic imaging / Medical imaging / Medical prognosis / Meta-analysis / Mortality / Oral cancer / Oral Health / Quality standards / Systematic review / Tomography