Lesion-Aware Cross-Phase Attention Network for Renal Tumor Subtype Classification on Multi-Phase CT Scans

Multi-phase computed tomography (CT) has been widely used for the preoperative diagnosis of kidney cancer due to its non-invasive nature and ability to characterize renal lesions. However, since enhancement patterns of renal lesions across CT phases are different even for the same lesion type, the visual assessment by radiologists suffers from inter-observer variability in clinical practice. Although deep learning-based approaches have been recently explored for differential diagnosis of kidney cancer, they do not explicitly model the relationships between CT phases in the network design, limiting the diagnostic performance. In this paper, we propose a novel lesion-aware cross-phase attention network (LACPANet) that can effectively capture temporal dependencies of renal lesions across CT phases to accurately classify the lesions into five major pathological subtypes from time-series multi-phase CT images. We introduce a 3D inter-phase lesion-aware attention mechanism to learn effective 3D lesion features that are used to estimate attention weights describing the inter-phase relations of the enhancement patterns. We also present a multi-scale attention scheme to capture and aggregate temporal patterns of lesion features at different spatial scales for further improvement. Extensive experiments on multi-phase CT scans of kidney cancer patients from the collected dataset demonstrate that our LACPANet outperforms state-of-the-art approaches in diagnostic accuracy.

A Unified Multi-Phase CT Synthesis and Classification Framework for Kidney Cancer Diagnosis with Incomplete Data

Multi-phase CT is widely adopted for the diagnosis of kidney cancer due to the complementary information among phases. However, the complete set of multi-phase CT is often not available in practical clinical applications. In recent years, there have been some studies to generate the missing modality image from the available data. Nevertheless, the generated images are not guaranteed to be effective for the diagnosis task. In this paper, we propose a unified framework for kidney cancer diagnosis with incomplete multi-phase CT, which simultaneously recovers missing CT images and classifies cancer subtypes using the completed set of images. The advantage of our framework is that it encourages a synthesis model to explicitly learn to generate missing CT phases that are helpful for classifying cancer subtypes. We further incorporate lesion segmentation network into our framework to exploit lesion-level features for effective cancer classification in the whole CT volumes. The proposed framework is based on fully 3D convolutional neural networks to jointly optimize both synthesis and classification of 3D CT volumes. Extensive experiments on both in-house and external datasets demonstrate the effectiveness of our framework for the diagnosis with incomplete data compared with state-of-the-art baselines. In particular, cancer subtype classification using the completed CT data by our method achieves higher performance than the classification using the given incomplete data.

Exploring 3D U-Net Training Configurations and Post-Processing Strategies for the MICCAI 2023 Kidney and Tumor Segmentation Challenge

In 2023, it is estimated that 81,800 kidney cancer cases will be newly diagnosed, and 14,890 people will die from this cancer in the United States. Preoperative dynamic contrast-enhanced abdominal computed tomography (CT) is often used for detecting lesions. However, there exists inter-observer variability due to subtle differences in the imaging features of kidney and kidney tumors. In this paper, we explore various 3D U-Net training configurations and effective post-processing strategies for accurate segmentation of kidneys, cysts, and kidney tumors in CT images. We validated our model on the dataset of the 2023 Kidney and Kidney Tumor Segmentation (KiTS23) challenge. Our method took second place in the final ranking of the KiTS23 challenge on unseen test data with an average Dice score of 0.820 and an average Surface Dice of 0.712.