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This systematic review reveals a critical gap in lung cancer AI literature, where the vast majority of studies focus on detection rather than genuine future risk prediction or robust clinical validation. The analysis highlights that only 10.6% of reviewed papers successfully complete a full translational evidence chain, with significant attrition occurring specifically at stages requiring reasoning and explainability. For researchers and clinicians, this underscores the urgent need to shift from simple classification tasks toward rigorous evaluation of model calibration, external generalizability, and causal inference in real-world settings.
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Disentangling Lung-Cancer CT/LDCT AI: A Systematic Evidence Map of Clinical Tasks, Evidence Chains, and Translational Gaps

arXiv2 min read

arXiv:2609.35240v1 Announce Type: new Abstract: Artificial-intelligence studies using computed tomography (CT) for lung cancer are often broadly labelled "prediction" despite addressing clinically distinct tasks. We systematically mapped CT/low-dose CT (LDCT)-centered lung-cancer AI using five-database retrieval, full-text eligibility assessment, role-aware modality/omics extraction, clinical-task classification, and a Multi-Tier Evidence Graph (MTEG). The final corpus comprised 293 studies (2016-2026): 230 Detection, 8 future Risk-prediction, and 55 Other studies. Clinical variables (96.2%), 3D CT/LDCT (73.0%), and radiomics (63.5%) predominated, whereas external validation (29.0%), calibration (20.5%), decision-curve analysis (13.0%), longitudinal CT (17.7%), and saliency/attribution XAI (21.5%) were less frequent. The MTEG comprised 377 nodes and 3,444 edges; only 31 studies (10.6%) completed the six-tier substantive evidence chain, with greatest attrition at reasoning/explanation. Overall, the literature is detection-dominated, genuine future risk prediction remains uncommon, and complete translational evidence chains are rare.

Abstract:Artificial-intelligence studies using computed tomography (CT) for lung cancer are often broadly labelled "prediction" despite addressing clinically distinct tasks. We systematically mapped CT/low-dose CT (LDCT)-centered lung-cancer AI using five-database retrieval, full-text eligibility assessment, role-aware modality/omics extraction, clinical-task classification, and a Multi-Tier Evidence Graph (MTEG). The final corpus comprised 293 studies (2016-2026): 230 Detection, 8 future Risk-prediction, and 55 Other studies. Clinical variables (96.2%), 3D CT/LDCT (73.0%), and radiomics (63.5%) predominated, whereas external validation (29.0%), calibration (20.5%), decision-curve analysis (13.0%), longitudinal CT (17.7%), and saliency/attribution XAI (21.5%) were less frequent. The MTEG comprised 377 nodes and 3,444 edges; only 31 studies (10.6%) completed the six-tier substantive evidence chain, with greatest attrition at reasoning/explanation. Overall, the literature is detection-dominated, genuine future risk prediction remains uncommon, and complete translational evidence chains are rare.

Machine Learning (cs.LG)

arXiv:2609.35240 [cs.LG]

(or arXiv:2609.35240v1 [cs.LG] for this version)

https://doi.org/10.48550/arXiv.2609.35240 Focus to learn more arXiv-issued DOI via DataCite (pending registration)

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Full text under the publisher's open licence · 224 words

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