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.
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.