Imaging-Based AI for Predicting Lymphovascular Space Invasion in Cervical Cancer: Systematic Review and Meta-Analysis

Abstract BackgroundThe role of artificial intelligence (AI) in enhancing the accuracy of lymphovascular space invasion (LVSI) detection in cervical cancer remains debated. ObjectiveThis meta-analysis aimed to evaluate the diagnostic accuracy of imaging-based AI for...

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Main Authors: Lizhen She, Yunfeng Li, Hongyong Wang, Jun Zhang, Yuechen Zhao, Jie Cui, Ling Qiu
Format: Article
Language:English
Published: JMIR Publications 2025-06-01
Series:Journal of Medical Internet Research
Online Access:https://www.jmir.org/2025/1/e71091
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author Lizhen She
Yunfeng Li
Hongyong Wang
Jun Zhang
Yuechen Zhao
Jie Cui
Ling Qiu
author_facet Lizhen She
Yunfeng Li
Hongyong Wang
Jun Zhang
Yuechen Zhao
Jie Cui
Ling Qiu
author_sort Lizhen She
collection DOAJ
description Abstract BackgroundThe role of artificial intelligence (AI) in enhancing the accuracy of lymphovascular space invasion (LVSI) detection in cervical cancer remains debated. ObjectiveThis meta-analysis aimed to evaluate the diagnostic accuracy of imaging-based AI for predicting LVSI in cervical cancer. MethodsWe conducted a comprehensive literature search across multiple databases, including PubMed, Embase, and Web of Science, identifying studies published up to November 9, 2024. Studies were included if they evaluated the diagnostic performance of imaging-based AI models in detecting LVSI in cervical cancer. We used a bivariate random-effects model to calculate pooled sensitivity and specificity with corresponding 95% confidence intervals. Study heterogeneity was assessed using the I2 ResultsOf 403 studies identified, 16 studies (2514 patients) were included. For the interval validation set, the pooled sensitivity, specificity, and area under the curve (AUC) for detecting LVSI were 0.84 (95% CI 0.79-0.87), 0.78 (95% CI 0.75-0.81), and 0.87 (95% CI 0.84-0.90). For the external validation set, the pooled sensitivity, specificity, and AUC for detecting LVSI were 0.79 (95% CI 0.70-0.86), 0.76 (95% CI 0.67-0.83), and 0.84 (95% CI 0.81-0.87). Using the likelihood ratio test for subgroup analysis, deep learning demonstrated significantly higher sensitivity compared to machine learning (PP ConclusionsImaging-based AI, particularly deep learning algorithms, demonstrates promising diagnostic performance in predicting LVSI in cervical cancer. However, the limited external validation datasets and the retrospective nature of the research may introduce potential biases. These findings underscore AI’s potential as an auxiliary diagnostic tool, necessitating further large-scale prospective validation.
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spelling doaj-art-6a2a4141c1eb4777b0d04ca1aa2c12232025-08-20T03:30:08ZengJMIR PublicationsJournal of Medical Internet Research1438-88712025-06-0127e71091e7109110.2196/71091Imaging-Based AI for Predicting Lymphovascular Space Invasion in Cervical Cancer: Systematic Review and Meta-AnalysisLizhen Shehttp://orcid.org/0009-0000-3879-7308Yunfeng Lihttp://orcid.org/0000-0003-0084-6658Hongyong Wanghttp://orcid.org/0009-0009-5824-8344Jun Zhanghttp://orcid.org/0009-0004-5189-6019Yuechen Zhaohttp://orcid.org/0000-0002-7098-5322Jie Cuihttp://orcid.org/0009-0007-5768-3323Ling Qiuhttp://orcid.org/0000-0002-2564-2240 Abstract BackgroundThe role of artificial intelligence (AI) in enhancing the accuracy of lymphovascular space invasion (LVSI) detection in cervical cancer remains debated. ObjectiveThis meta-analysis aimed to evaluate the diagnostic accuracy of imaging-based AI for predicting LVSI in cervical cancer. MethodsWe conducted a comprehensive literature search across multiple databases, including PubMed, Embase, and Web of Science, identifying studies published up to November 9, 2024. Studies were included if they evaluated the diagnostic performance of imaging-based AI models in detecting LVSI in cervical cancer. We used a bivariate random-effects model to calculate pooled sensitivity and specificity with corresponding 95% confidence intervals. Study heterogeneity was assessed using the I2 ResultsOf 403 studies identified, 16 studies (2514 patients) were included. For the interval validation set, the pooled sensitivity, specificity, and area under the curve (AUC) for detecting LVSI were 0.84 (95% CI 0.79-0.87), 0.78 (95% CI 0.75-0.81), and 0.87 (95% CI 0.84-0.90). For the external validation set, the pooled sensitivity, specificity, and AUC for detecting LVSI were 0.79 (95% CI 0.70-0.86), 0.76 (95% CI 0.67-0.83), and 0.84 (95% CI 0.81-0.87). Using the likelihood ratio test for subgroup analysis, deep learning demonstrated significantly higher sensitivity compared to machine learning (PP ConclusionsImaging-based AI, particularly deep learning algorithms, demonstrates promising diagnostic performance in predicting LVSI in cervical cancer. However, the limited external validation datasets and the retrospective nature of the research may introduce potential biases. These findings underscore AI’s potential as an auxiliary diagnostic tool, necessitating further large-scale prospective validation.https://www.jmir.org/2025/1/e71091
spellingShingle Lizhen She
Yunfeng Li
Hongyong Wang
Jun Zhang
Yuechen Zhao
Jie Cui
Ling Qiu
Imaging-Based AI for Predicting Lymphovascular Space Invasion in Cervical Cancer: Systematic Review and Meta-Analysis
Journal of Medical Internet Research
title Imaging-Based AI for Predicting Lymphovascular Space Invasion in Cervical Cancer: Systematic Review and Meta-Analysis
title_full Imaging-Based AI for Predicting Lymphovascular Space Invasion in Cervical Cancer: Systematic Review and Meta-Analysis
title_fullStr Imaging-Based AI for Predicting Lymphovascular Space Invasion in Cervical Cancer: Systematic Review and Meta-Analysis
title_full_unstemmed Imaging-Based AI for Predicting Lymphovascular Space Invasion in Cervical Cancer: Systematic Review and Meta-Analysis
title_short Imaging-Based AI for Predicting Lymphovascular Space Invasion in Cervical Cancer: Systematic Review and Meta-Analysis
title_sort imaging based ai for predicting lymphovascular space invasion in cervical cancer systematic review and meta analysis
url https://www.jmir.org/2025/1/e71091
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AT hongyongwang imagingbasedaiforpredictinglymphovascularspaceinvasionincervicalcancersystematicreviewandmetaanalysis
AT junzhang imagingbasedaiforpredictinglymphovascularspaceinvasionincervicalcancersystematicreviewandmetaanalysis
AT yuechenzhao imagingbasedaiforpredictinglymphovascularspaceinvasionincervicalcancersystematicreviewandmetaanalysis
AT jiecui imagingbasedaiforpredictinglymphovascularspaceinvasionincervicalcancersystematicreviewandmetaanalysis
AT lingqiu imagingbasedaiforpredictinglymphovascularspaceinvasionincervicalcancersystematicreviewandmetaanalysis