The use of Artificial Intelligence in Diagnosis of Thymic Cancer - Systematic review and Meta Analysis

Background Thymomas are rare mediastinal tumors with broad clinical spectrum, making accurate diagnosis pivotal for treatment planning and prognostication. Conventional imaging and histopathological evaluation persist as the gold standard, however, recent advances in artificial intelligence (AI) have introduced innovative methodologies to enhance diagnostic precision, reproducibility, and efficiency. This systematic review aimed to evaluate the current evidence on the application of AI-based methods in the diagnosis of thymoma. Methods A systematic search was conducted across Pubmed, Web of science, Embase, Scopus, BioRxiv, IEEE Xplore, Digital Library ACM. Eligible studies included original research that investigated AI techniques—such as machine learning, deep learning, or radiomics—for diagnosing or classifying thymoma, based on imaging, pathology, or multimodal data. Data were extracted on AI methodology, diagnostic performance metrics, number of participants, and country of origin. Methodological quality was assessed using APPRAISE-AI. Results 26 studies met inclusion criteria. AI models outperformed radiologists and pathologists in all comparisons, although in some metric models were significantly better than medical professionals. For all outcomes, the top-performing models achieved an Area Under the Curve (AUC) close to 0.95, while mean performance values were comparatively lower. Conclusion AI models typically exhibit diagnostic performance equivalent to radiologists, showing incremental advantages in selected applications. The most favorable outcomes have been observed in differential diagnosis, followed by pathology and risk stratification, with deep learning demonstrating particular effectiveness in pathology. Nevertheless, further investigations incorporating diverse imaging modalities, deep learning approaches, and strategies aimed at augmenting medical professionals’ performance are still required.