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AI Algorithm Outperforms Radiologists in Measuring Cancer Spread on CT Scans

By MedImaging International staff writers
Posted on 24 Oct 2022

Image: The new AI algorithm demonstrated superior accuracy in measuring extent of cancer spread (Photo courtesy of Pexels)

Head and neck cancers and their standard treatments - surgery, radiation, or chemotherapy - carry significant morbidity. They affect how a person looks, talks, eats, or breathes. Therefore, there is great interest in developing less intense treatment strategies for patients. Among the factors that determine the cancer stage are the size of the original tumor, the number of lymph nodes involved, and extranodal extension - when malignant cells spread beyond the borders of the neck lymph nodes into the surrounding tissue. Now, new research has demonstrated that artificial intelligence (AI) can augment current methods to predict the risk that head and neck cancer will spread outside the borders of neck lymph nodes.

In a study by researchers with the ECOG-ACRIN Cancer Research Group (ECOG-ACRIN, Philadelphia, PA, USA), a customized deep learning algorithm using standard computed tomography (CT) scan images and associated data contributed by patients who participated in the E3311 phase 2 trial showed promise, especially for patients with a new diagnosis of human papillomavirus (HPV)-related head and neck cancer. The E3311 validated dataset carries the potential to contribute to the more accurate staging of disease and prediction of risk. The completed E3311 phase 2 trial showed that low-dose radiation at 50 Gray (Gy) without chemotherapy following transoral surgery led to very high survival and outstanding quality of life in patients at medium risk for recurrence.

The researchers developed and validated a neural network-based deep learning algorithm based on diagnostic CT scans, pathology, and clinical data. The source was the cohort of participants in the E3311 trial who were assessed at high risk of recurrence by standard pathologic and clinical measures. In E3311, patients were assessed as high risk if there was ≥1 mm extranodal extension (ENE). These patients were assigned to chemotherapy and high-dose radiation (66 Gy) following transoral surgery.

The researchers obtained pre-treatment CT scans and corresponding surgical pathology reports from the E3311 high-risk cohort, as available. From 177 collected scans, 311 nodes were annotated: 71 (23%) with ENE and 39 (13%) with ≥1 mm ENE. The tool showed high performance in predicting ENE, substantially outperforming the reviews by expert head and neck radiologists. The team now plans to evaluate the dataset as part of future treatment trials for head and neck cancer. The algorithm will be assessed for its potential to improve upon current disease staging and risk assessment methods.

“The deep learning algorithm accurately classified 85% of the nodes as having ENE compared to 70% by the radiologists,” said Benjamin Kann, MD, who led the study for ECOG-ACRIN. “As to specificity and sensitivity, the deep learning algorithm was 78% accurate versus 62% by the radiologists.”

"Our ability to develop biomarkers from standard CT scan images is an exciting new area of clinical research and provides the hope that we will be able to better tailor treatment for individual patients, including deciding when to best use surgery and in whom to reduce the extent of treatment," added senior author Barbara A. Burtness, MD.

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67 (29.087066650391): select jos_linkedin.link from jos_linkedin where cat=10

68 (32.186508178711): SELECT fid FROM jos_deeppockets WHERE id=294795055 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294795055 AND published='1' LIMIT 1

69 (39.100646972656): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=215 ORDER BY `ordering`

70 (378.13186645508): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294795055 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (236.03439331055): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294795055 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (40.054321289062): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (50.067901611328): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (!!!!! 2182.9605102539): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (77.009201049805): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (57.93571472168): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294795055 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (30.994415283203): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294795055 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (35.04753112793): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (74.863433837891): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (!!!!! 3395.0805664062): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (76.055526733398): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (82.015991210938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795055 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795055 AND published='1' LIMIT 1

105 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795055 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795055 AND published='1' LIMIT 1

106 (55.074691772461): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294795055 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (489.95018005371): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294795055 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (95.844268798828): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795055 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795055 AND published='1' LIMIT 1

109 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795055 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795055 AND published='1' LIMIT 1

110 (78.916549682617): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294795055 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (550.0316619873): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294795055 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (!!!!! 4929.0657043457): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (600.09956359863): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (80.82389831543): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795055 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795055 AND published='1' LIMIT 1

115 (58.174133300781): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795055 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795055 AND published='1' LIMIT 1

116 (58.889389038086): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795055 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795055 AND published='1' LIMIT 1

117 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795055 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795055 AND published='1' LIMIT 1

118 (57.220458984375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795055 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795055 AND published='1' LIMIT 1

119 (40.054321289062): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795055 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795055 AND published='1' LIMIT 1

120 (324.01084899902): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 47955.03616333): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

122 (!!!!! 1506.0901641846): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795055 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795055 AND published='1' LIMIT 1

123 (62.942504882812): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795055 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795055 AND published='1' LIMIT 1

124 (512.12310791016): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294795055 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294795055 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 1516990.9000397): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (!!!!! 1965.9996032715): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (50.067901611328): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (29.087066650391): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (44.107437133789): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (27.894973754883): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (27.894973754883): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (27.894973754883): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (452.99530029297): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795055 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (341.89224243164): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795055 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (185.01281738281): SELECT name FROM jos_deeppockets WHERE id=215

136 (42.915344238281): SELECT name FROM jos_deeppockets WHERE id=215

137 (590.80123901367): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (530.00450134277): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (86.069107055664): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795055 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795055 AND published='1' LIMIT 1

140 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795055 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795055 AND published='1' LIMIT 1

141 (!!!!! 10186.910629272): TRUNCATE TABLE jos_trademed_module

142 (859.02214050293): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294795055 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (70.810317993164): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294795055 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (463.96255493164): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795055 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795055 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (52.213668823242): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795055 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795055 AND published='1' LIMIT 1

147 (40.054321289062): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795055 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795055 AND published='1' LIMIT 1

148 (!!!!! 1089.0960693359): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

149 (99.897384643555): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795055 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795055 AND published='1' LIMIT 1

150 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795055 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795055 AND published='1' LIMIT 1

151 (403.88107299805): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294795055 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294795055 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (658.03527832031): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

153 (!!!!! 3360.9867095947): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

154 (57.93571472168): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (!!!!! 3027.9159545898): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795055 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795055 AND published='1' LIMIT 1

156 (64.849853515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294795055 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294795055 AND published='1' LIMIT 1

157 (56.028366088867): select jos_twitters.link from jos_twitters where cat=10

158 (28.133392333984): select jos_facebook.link from jos_facebook where cat=10

159 (25.98762512207): select jos_google_plus.link from jos_google_plus where cat=10

160 (25.98762512207): select jos_linkedin.link from jos_linkedin where cat=10

161 (307.08312988281): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 10267.972946167): insert into jos_banners_delta values (14615,'2025-04-30 18:23:00','18.221.72.117','view'),(14202,'2025-04-30 18:23:00','18.221.72.117','view'),(14203,'2025-04-30 18:23:00','18.221.72.117','view')

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