By the end of 2023, otolaryngologists in Europe may be using an artificial intelligence (AI) system to diagnose laryngeal cancer.
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January 2023The Zeno AI system, which analyzes images in real time during laryngoscopy, is currently under evaluation by European regulatory authorities and may be commercially available in Europe as early as mid-2023, according to Marius Wellenstein, chief operations officer and co-founder of WSK Medical in Amsterdam, Netherlands, the company that developed Zeno AI.
“This is a real-time closed system that is able to detect and distinguish cancer or benign lesions in the larynx,” said Wellenstein, noting that the system may allow otolaryngologists who do not specialize in head and neck cancer to evaluate laryngeal lesions more effectively.
In testing, Zeno AI correctly localized and classified vocal cord carcinoma in 71% and 78% of the cases in the validation and test set, respectively, and 70% to 82% of benign vocal cord lesions, according to a clinical evaluation report provided by WSK Medical. The system is currently in use at two European academic medical centers.
Is this the future of otolaryngology? Will humans someday rely on computers to detect, diagnose, and direct the treatment of head and neck cancer, dysphagia, otitis media, balance disorders, sinusitis, and other disorders of the ears, nose, and throat?
Yes. And probably not.
Some studies have already found that “a physician with the assistance of an AI algorithm is able to perform better than a physician without the AI algorithm,” said Andrés M. Bur, MD, an associate professor of otolaryngology–head and neck surgery and director of robotic and minimally invasive head and neck surgery at the University of Kansas in Lawrence. “AI has the potential to reduce the likelihood of missing something or making an error.”
If we can develop machine learning models that are highly accurate, patients who are at low risk may not need to undergo any neck surgery. —Andrés M. Bur, MD
But AI is not intended to be a standalone diagnostic modality or disease management tool.
“AI’s role is not to replace physicians; it’s to augment our abilities,” said Aaron Moberly, MD, an associate professor in both the department of otolaryngology–head and neck surgery and the department of hearing and speech sciences at Vanderbilt University Medical Center in Nashville, Tenn.
Computers can sift through vast amounts of data far faster than humans can, so computer-driven systems can spot patterns and connections that may be difficult for humans to perceive. Human physicians, though, will remain an integral part of healthcare for the foreseeable future. For while many researchers are investigating potential applications of artificial intelligence in otolaryngology, no AI-based tools have yet been approved for clinical use in otolaryngology in the United States, in part because the field lacks large, labeled datasets that can be used to train computer algorithms. In addition, researchers, physicians, regulatory agencies, and the public aren’t yet confident that AI systems can be used safely for clinical care.