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Lung Nodule Malignancy Classification with Associated Pulmonary Fibrosis using 3D Attention-gated Convolutional Network with CT scans

Research Square
2023
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Metric Options:   Counts1 Year3 Year

Article Description

Background Chest Computed tomography (CT) scans detect lung nodules and assess pulmonary fibrosis. While pulmonary fibrosis indicates increased lung cancer risk, current clinical practice characterizes nodule risk of malignancy based on nodule size and smoking history; little consideration is given to the fibrotic microenvironment. Purpose To evaluate the effect of incorporating fibrotic microenvironment into classifying malignancy of lung nodules in chest CT images using deep learning techniques. Materials and Methods We developed a visualizable 3D classification model trained with in-house CT dataset for the nodule malignancy classification task. Three slightly-modified datasets were created: 1) nodule alone (microenvironment removed), 2) nodule with surrounding lung microenvironment, and 3) nodule in microenvironment with semantic fibrosis metadata. For each of the models, 10-fold cross-validation was performed. Results were evaluated using quantitative measures, such as accuracy, sensitivity, specificity, and area-under-curve (AUC), as well as qualitative assessments, such as attention maps and class activation maps (CAM). Results The classification model trained with nodule alone achieved 75.61% accuracy, 50.00% sensitivity, 88.46% specificity, and 0.78 AUC; the model trained with nodule and microenvironment achieved 79.03% accuracy, 65.46% sensitivity, 85.86% specificity, and 0.84 AUC. The model trained with additional semantic fibrosis metadata achieved 80.84% accuracy, 74.67% sensitivity, 84.95% specificity, and 0.89 AUC. Our visual evaluation of attention maps and CAM suggested that both the nodules and the microenvironment contributed to the task. Conclusion The nodule malignancy classification performance was found to be improving with microenvironment data. Further improvement was found when incorporating semantic fibrosis information.

Bibliographic Details

Yucheng Liu; Hao Yun Hsu; Tiffany Lin; Boyu Peng; Anjali Saqi; Mary M. Salvatore; Sachin R. Jambawalikar

Springer Science and Business Media LLC

Biochemistry, Genetics and Molecular Biology; Immunology and Microbiology; Medicine; Neuroscience; Psychology; Dentistry

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