May 29, 2024: Experts at Newcastle University have discovered that artificial intelligence software can play a transformative role in guiding the treatment of voice box cancer.

In pioneering research on advanced laryngeal cancer (or voice box cancer), Mr. Amar Rajgor and his team at Newcastle University have harnessed the power of artificial intelligence (AI) to analyze medical imaging from CT scans, aiming to predict survival outcomes.

Mr Rajgor, an ear, nose and throat specialist, said: “Radiomics can be seen as a super-powered magnifying glass for medical images, like CT scans. It carefully examines every tiny detail, even the ones that are hard to see. By doing this, it can find patterns and irregularities that cannot be seen by a human or might otherwise be missed.”

Laryngeal cancer poses a significant challenge in the UK, with approximately 2,400 new cases diagnosed each year. Of these, half of the patients in advanced stages do not survive beyond three years. However, the study led by Mr. Rajgor offers hope for enhanced care and treatment for these patients.

Unlocking the full potential

The AI software operates pixel by pixel, uncovering hidden patterns within the tumor that are invisible to the human eye. This technology functions as a “virtual biopsy,” providing insights into the cancer’s behavior and the extent of irregularity. This detailed image analysis method is known as radiomics.

The research, published in the Journal of Laryngology & Otology, identified two significant imaging markers: Shape Compactness and Grey Level Non-Uniformity (GLNU). High levels of these markers indicate a greater risk of early mortality for patients. Specifically, an increase in Shape Compactness nearly tripled the risk of death, while a rise in GLNU doubled it.

The study also found that these imaging markers were more accurate in predicting survival than traditional factors currently used by doctors, such as age or cancer stage.

While numerous studies analyze head and neck cancers collectively, they are often not robust or clinically relevant, as these cancers behave very differently. From a clinician’s perspective, it is important not to group them for analysis.

Mr Rajgor added: "These developments are very exciting, as this research could play a big role in guiding treatment and delivering precision medicine in the future. It could also ensure that patients get the right treatment for them, based on what their tumour looks like and how it behaves. I hope this will also help patients make more informed decisions about their treatment journey. Another benefit is that this method does not change the patient pathway but enhances it, by analysing medical images in a way that cannot be done by a human. Currently, much of the information from scans is not being fully utilized, but this allows us to unlock its full potential.

In the future, we could also use this technique to track how well a patient is responding to treatment by looking at scans over time.”

Potential to revolutionise voice box cancer management

Over the past 30 years, there has been little progress in improving survival rates for patients with voice box cancer. However, the collaboration between Newcastle University and Newcastle Upon Tyne Hospitals NHS Foundation Trust offers new hope for those fighting laryngeal cancer. This partnership has led to Amar Rajgor receiving a prestigious National Institute for Health and Care Research (NIHR) Doctoral Fellowship.

Mr Rajgor, concluded: "Further research will be done in this area. Following my award from NIHR, we are currently expanding the study to over 250 patients. We will aim to create a risk prediction model looking at both survival and response to specific cancer treatments. This prototype model will include clinical factors, pathology detail and imaging markers. This has the potential to truly revolutionise voice box cancer management.”

Amar Rajgor's systematic review highlights the shortcomings of current literature, and these issues have been addressed in this study.

Both Newcastle University and Newcastle Hospitals are part of Newcastle Health Innovation Partners (NHIP). NHIP is one of eight esteemed Academic Health Science Centres (AHSCs) in the UK, uniting partners to achieve excellence in research, health education, and patient care.

ABOUT NEWCASTLE UNIVERSITY: Newcastle University, UK, is a thriving international community of more than 28,000 students from over 130 countries worldwide. As a member of the Russell Group of research-intensive universities in the UK, Newcastle has a world-class reputation for research excellence in the fields of medicine, science and engineering, social sciences and the humanities. Its academics are sharply focused on responding to the major challenges facing society today. Our research and teaching are world-leading in areas as diverse as health, culture, technology and the environment. Newcastle University is committed to providing our students with excellent, research-led teaching delivered by dedicated and passionate teachers. Newcastle University is ranked 110th  in the QS World Ranking 2024 and 139th in the Times Higher Education World University Ranking 2023.