Chen Haozhong, Liu Jun, Deng Kai, Mei Xilong, Peng Dehong, Xiao Enhua
Department of Radiology, Second Xiangya Hospital, Central South University, Changsha 410011, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2025 Apr 28;50(4):651-663. doi: 10.11817/j.issn.1672-7347.2025.250082.
Renal cell carcinoma (RCC) is a malignant renal tumor that poses a significant threat to patient health. Accurate preoperative pathological grading plays a crucial role in determining the appropriate treatment for this disease. Currently, deep learning technology has become an important method for pathological grading of RCC. However, existing methods primarily rely on single-phase computed tomography (CT) imaging for analysis and prediction, which has limitations such as missing small lesions, one-sided evaluation, and local focusing issues. Therefore, this study proposes a multi-modal deep learning algorithm that integrates multi-phase enhanced CT images with clinical variable data, aiming to provide a basis for predicting the pathological grading of RCC.
First, the algorithm took four-phase enhanced CT images from the plain scan, arterial phase, venous phase, and delayed phase, along with clinical variables, as inputs. Then, an embedding encoding module was used to extract heterogeneous information from the clinical variables, and a 3-dimensional (3D) ResNet50 model was employed to capture spatial information from the multi-phase enhanced CT image data. Finally, a Fusion module deeply integrated the feature information from clinical variables and each phase's CT image features, further utilizing a cross-self-attention mechanism to achieve multi-phase feature fusion. This approach comprehensively captures the deep semantic information from the patient data, fully leveraging the complementary advantages of multi-modal and multi-phase data. To validate the effectiveness of the proposed method, a total of 1 229 RCC patients were approved by ethics review were included to train the model.
Experimental results demonstrated superior performance compared to traditional radiomics and state-of-the-art deep learning methods, achieving an accuracy of 83.87%, a recall rate of 95.04%, and an F1-score of 82.23%.
The proposed algorithm exhibits strong stability and sensitivity, significantly enhancing the predictive performance of RCC pathological grading. It offers a novel approach for accurate RCC diagnosis and personalized treatment planning.
肾细胞癌(RCC)是一种对患者健康构成重大威胁的恶性肾脏肿瘤。准确的术前病理分级对于确定该疾病的合适治疗方法起着至关重要的作用。目前,深度学习技术已成为RCC病理分级的重要方法。然而,现有方法主要依赖于单相计算机断层扫描(CT)成像进行分析和预测,存在诸如遗漏小病灶、评估片面以及局部聚焦问题等局限性。因此,本研究提出一种将多期增强CT图像与临床变量数据相结合的多模态深度学习算法,旨在为预测RCC的病理分级提供依据。
首先,该算法将平扫、动脉期、静脉期和延迟期的四期增强CT图像以及临床变量作为输入。然后,使用嵌入编码模块从临床变量中提取异构信息,并采用三维(3D)ResNet50模型从多期增强CT图像数据中捕获空间信息。最后,融合模块将临床变量的特征信息与各期CT图像特征进行深度整合,进一步利用交叉自注意力机制实现多期特征融合。这种方法全面捕捉患者数据中的深度语义信息,充分发挥多模态和多期数据的互补优势。为验证所提方法的有效性,共纳入1229例经伦理审查批准的RCC患者来训练模型。
实验结果表明,与传统放射组学和最先进的深度学习方法相比,该方法具有卓越的性能,准确率达到83.87%,召回率为95.04%,F1分数为82.23%。
所提算法具有很强的稳定性和敏感性,显著提高了RCC病理分级的预测性能。它为RCC的准确诊断和个性化治疗规划提供了一种新方法。