Improving Prognostic Performance in Resectable Pancreatic Ductal Adenocarcinoma using Radiomics and Deep Learning Features Fusion in CT Images

As an analytic pipeline for quantitative imaging feature extraction and analysis, radiomics has grown rapidly in the past a few years. Recent studies in radiomics aim to investigate the relationship between tumors imaging features and clinical outcomes. Open source radiomics feature banks enable the extraction and analysis of thousands of predefined features. On the other hand, recent advances in deep learning have shown significant potential in the quantitative medical imaging field, raising the research question of whether predefined radiomics features have predictive information in addition to deep learning features. In this study, we propose a feature fusion method and investigate whether a combined feature bank of deep learning and predefined radiomics features can improve the prognostics performance. CT images from resectable Pancreatic Adenocarcinoma (PDAC) patients were used to compare the prognosis performance of common feature reduction and fusion methods and the proposed risk-score based feature fusion method for overall survival. It was shown that the proposed feature fusion method significantly improves the prognosis performance for overall survival in resectable PDAC cohorts, elevating the area under ROC curve by 51% compared to predefined radiomics features alone, by 16% compared to deep learning features alone, and by 32% compared to existing feature fusion and reduction methods for a combination of deep learning and predefined radiomics features.

CNN-based Survival Model for Pancreatic Ductal Adenocarcinoma in Medical Imaging

Cox proportional hazard model (CPH) is commonly used in clinical research for survival analysis. In quantitative medical imaging (radiomics) studies, CPH plays an important role in feature reduction and modeling. However, the underlying linear assumption of CPH model limits the prognostic performance. In addition, the multicollinearity of radiomic features and multiple testing problem further impedes the CPH models performance. In this work, using transfer learning, a convolutional neural network (CNN) based survival model was built and tested on preoperative CT images of resectable Pancreatic Ductal Adenocarcinoma (PDAC) patients. The proposed CNN-based survival model outperformed the traditional CPH-based radiomics approach in terms of concordance index by 22%, providing a better fit for patients' survival patterns. The proposed CNN-based survival model outperforms CPH-based radiomics pipeline in PDAC prognosis. This approach offers a better fit for survival patterns based on CT images and overcomes the limitations of conventional survival models.

Improving Prognostic Value of CT Deep Radiomic Features in Pancreatic Ductal Adenocarcinoma Using Transfer Learning

Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive cancers with an extremely poor prognosis. Radiomics has shown prognostic ability in multiple types of cancer including PDAC. However, the prognostic value of traditional radiomics pipelines, which are based on hand-crafted radiomic features alone, is limited due to multicollinearity of features and multiple testing problem, and limited performance of conventional machine learning classifiers. Deep learning architectures, such as convolutional neural networks (CNNs), have been shown to outperform traditional techniques in computer vision tasks, such as object detection. However, they require large sample sizes for training which limits their development. As an alternative solution, CNN-based transfer learning has shown the potential for achieving reasonable performance using datasets with small sample sizes. In this work, we developed a CNN-based transfer learning approach for prognostication in PDAC patients for overall survival. The results showed that transfer learning approach outperformed the traditional radiomics model on PDAC data. A transfer learning approach may fill the gap between radiomics and deep learning analytics for cancer prognosis and improve performance beyond what CNNs can achieve using small datasets.