Automated Segmentation and Recurrence Risk Prediction of Surgically Resected Lung Tumors with Adaptive Convolutional Neural Networks

Lung cancer is the leading cause of cancer related mortality by a significant margin. While new technologies, such as image segmentation, have been paramount to improved detection and earlier diagnoses, there are still significant challenges in treating the disease. In particular, despite an increased number of curative resections, many postoperative patients still develop recurrent lesions. Consequently, there is a significant need for prognostic tools that can more accurately predict a patient's risk for recurrence. In this paper, we explore the use of convolutional neural networks (CNNs) for the segmentation and recurrence risk prediction of lung tumors that are present in preoperative computed tomography (CT) images. First, expanding upon recent progress in medical image segmentation, a residual U-Net is used to localize and characterize each nodule. Then, the identified tumors are passed to a second CNN for recurrence risk prediction. The system's final results are produced with a random forest classifier that synthesizes the predictions of the second network with clinical attributes. The segmentation stage uses the LIDC-IDRI dataset and achieves a dice score of 70.3%. The recurrence risk stage uses the NLST dataset from the National Cancer institute and achieves an AUC of 73.0%. Our proposed framework demonstrates that first, automated nodule segmentation methods can generalize to enable pipelines for a wide range of multitask systems and second, that deep learning and image processing have the potential to improve current prognostic tools. To the best of our knowledge, it is the first fully automated segmentation and recurrence risk prediction system.