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AI Can Help Radiologists Avoid Missed Lung Cancer on Chest X-Ray Images

By MedImaging International staff writers
Posted on 20 Apr 2023

Image: A new study has found some common features of missed lung cancer cases on chest X-ray images (Photo courtesy of Freepik)

Chest radiography is the most frequently performed first-line imaging examination, often used for routine health checkups, preoperative evaluations, and lung cancer screenings in primary healthcare settings worldwide. However, false-negative or misleading chest radiography results are common, and unexpected abnormalities like lung cancer may be overlooked. Missing lung cancer can result in the disease progressing from an early-stage, potentially curable state to advanced-stage lung cancer, leading to poor patient outcomes. Now, a recent analysis has identified common features of missed lung cancer cases on chest X-ray images, suggesting that computer-aided detection systems or artificial intelligence could assist radiologists in avoiding such errors.

Researchers at Ramathibodi Hospital (Bangkok, Thailand) analyzed chest X-rays from 75 patients at a single institution, where initial signs of lung cancer were overlooked. They found common features of missed lung cancer cases, including the tumor's location, density, and any superimposed anatomical structures. According to the researchers, radiologists can prevent such errors by comparing the chest radiograph being read with previous examples, focusing on common blind spots, avoiding misidentification of lesions as normal structures, and using computer-aided detection systems or artificial intelligence.

The study retrospectively reviewed chest X-rays of 95 patients taken at least six months before a lung cancer diagnosis. The final sample consisted of 75 patients, with an even gender distribution and an average age of nearly 65 years. The median missed lung cancer size was approximately 16 mm. Most cases (75%) occurred in the outer two-thirds of the lung, followed by 68% in the middle/lower zones and 55% in the left lung. Common features included anatomical superimposition (88% of cases), density lower than the aortic knob (85%), partly or poorly defined margin (77%), irregular or spiculated border (61%), and rounded or oval shape (57%). Almost 47% of the missed cases had stage 3 or 4 lung cancer, and 41% of patients died.

The findings indicate that certain radiographic features of missed lung cancer, such as density, location, and superimposed anatomical structures, identified in the first positive chest radiograph were linked to advanced-stage lung cancer diagnosis and higher 3-year all-cause mortality. Delayed detection of missed lung cancer with such radiographic features on chest radiography may lead to worse outcomes. Hence, radiologists should pay special attention to and promptly report equivocal or borderline lesions in the upper zone or inner one-third of the lung, those with density equal to or greater than the aortic knob, or those superimposed by midline structures, pulmonary vessels, and ribs found incidentally on chest radiographs. The researchers hope that these findings will help radiologists avoid errors that can result in poor patient outcomes and death. Furthermore, computer-aided detection systems or artificial intelligence could improve radiologist performance and help detect smaller tumors, suggested the researchers.

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69 (55.074691772461): 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=211 ORDER BY `ordering`

70 (480.89027404785): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294796905 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (260.1146697998): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294796905 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (445.12748718262): 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 (!!!!! 4513.0252838135): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (!!!!! 7919.0731048584): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (!!!!! 7893.0854797363): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (!!!!! 7972.9557037354): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (!!!!! 7899.0459442139): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (!!!!! 7979.154586792): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (!!!!! 7919.0731048584): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (!!!!! 7967.9489135742): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (!!!!! 7858.0379486084): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (!!!!! 8000.8506774902): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (!!!!! 7862.0910644531): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (!!!!! 7993.9365386963): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (340.93856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (!!!!! 1877.0694732666): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (51.021575927734): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294796905 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (28.133392333984): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294796905 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (31.948089599609): 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 (293.01643371582): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (334.9781036377): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (378.13186645508): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (187.87384033203): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (75.101852416992): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (!!!!! 4784.8224639893): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (272.98927307129): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (341.89224243164): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (330.92498779297): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (78.916549682617): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796905 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796905 AND published='1' LIMIT 1

105 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796905 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796905 AND published='1' LIMIT 1

106 (586.98654174805): 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=294796905 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (!!!!! 2214.1933441162): 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=294796905 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (835.18028259277): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796905 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796905 AND published='1' LIMIT 1

109 (!!!!! 1183.9866638184): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796905 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796905 AND published='1' LIMIT 1

110 (741.00494384766): 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=294796905 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (605.10635375977): 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=294796905 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (582.93342590332): 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 (829.93507385254): 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 (87.976455688477): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796905 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796905 AND published='1' LIMIT 1

115 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796905 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796905 AND published='1' LIMIT 1

116 (101.08947753906): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796905 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796905 AND published='1' LIMIT 1

117 (40.054321289062): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796905 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796905 AND published='1' LIMIT 1

118 (63.180923461914): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796905 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796905 AND published='1' LIMIT 1

119 (37.908554077148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796905 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796905 AND published='1' LIMIT 1

120 (158.07151794434): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 55867.195129395): 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 (!!!!! 6779.9091339111): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796905 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796905 AND published='1' LIMIT 1

123 (77.962875366211): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796905 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796905 AND published='1' LIMIT 1

124 (389.09912109375): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294796905 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294796905 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 883404.97016907): ( 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 (!!!!! 9202.9571533203): ( 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 (130.17654418945): 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 (525.95138549805): 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 (130.89179992676): 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 (74.863433837891): 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 (66.995620727539): 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 (60.081481933594): 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 (!!!!! 1374.9599456787): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796905 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (!!!!! 5503.8928985596): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796905 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (768.89991760254): SELECT name FROM jos_deeppockets WHERE id=211

136 (454.18739318848): SELECT name FROM jos_deeppockets WHERE id=211

137 (!!!!! 1674.8905181885): 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 '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (!!!!! 1612.9016876221): 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 '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (!!!!! 1128.9119720459): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796905 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796905 AND published='1' LIMIT 1

140 (420.09353637695): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796905 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796905 AND published='1' LIMIT 1

141 (!!!!! 16433.000564575): TRUNCATE TABLE jos_trademed_module

142 (!!!!! 3026.008605957): 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=294796905 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (!!!!! 3523.1113433838): 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=294796905 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (!!!!! 1150.1312255859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796905 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (158.07151794434): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796905 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (817.06047058105): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796905 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796905 AND published='1' LIMIT 1

147 (428.19976806641): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796905 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796905 AND published='1' LIMIT 1

148 (!!!!! 4045.9632873535): 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 (581.02607727051): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796905 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796905 AND published='1' LIMIT 1

150 (230.07392883301): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796905 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796905 AND published='1' LIMIT 1

151 (!!!!! 5106.9259643555): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294796905 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294796905 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (298.02322387695): 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=211 or channel_id is null)

153 (40.054321289062): 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=211 or channel_id is null)

154 (!!!!! 1101.9706726074): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (!!!!! 2144.0982818604): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796905 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796905 AND published='1' LIMIT 1

156 (!!!!! 3118.9918518066): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294796905 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294796905 AND published='1' LIMIT 1

157 (93.936920166016): select jos_twitters.link from jos_twitters where cat=10

158 (123.02398681641): select jos_facebook.link from jos_facebook where cat=10

159 (118.01719665527): select jos_google_plus.link from jos_google_plus where cat=10

160 (463.96255493164): select jos_linkedin.link from jos_linkedin where cat=10

161 (!!!!! 1383.0661773682): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 1669.8837280273): insert into jos_banners_delta values (14615,'2025-04-30 10:47:34','18.191.163.22','view'),(14202,'2025-04-30 10:47:34','18.191.163.22','view'),(14203,'2025-04-30 10:47:34','18.191.163.22','view')

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