<p>Accurate classification of renal masses before treatment is crucial for therapeutic decision-making and patient outcome. This study developed and validated Multi-Phase Attention Network (MPANet), a multimodal deep learning model integrating multiphase contrast-enhanced CT and clinical information, which can utilize both complete-phase and missing-phase CT data for multiclass classification of four common and easily confusable renal tumors—clear cell renal cell carcinoma (ccRCC), papillary renal cell carcinoma (pRCC), oncocytic neoplasms (including chromophobe renal cell carcinoma (chRCC) and renal oncocytoma (RO)), and fat-poor angiomyolipoma (fpAML). A total of 1688 multi-center cases were enrolled. Across all test sets, MPANet consistently outperformed single-phase models. In the internal test set, MPANet achieved a macro-average AUC of 0.850, a micro-average AUC of 0.865, and an accuracy of 73.3%. These results compared favorably to assessments by four radiologists based on CT (accuracies 43.6–62.4%) and two radiologists using MRI with clear cell likelihood score (ccLS) system (accuracies 52.5% and 49.5%). The net improvement rate of MPANet over radiologist assessment ranged from 10.9% to 29.7%. In the two external test sets, macro-average AUCs were 0.811 and 0.813, and micro-average AUCs were 0.867 and 0.909, respectively. MPANet shows potential as a clinical decision-support tool for personalized renal tumor diagnosis.</p>

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Multimodal deep learning model for multiclass classification of renal tumors

  • Shiwei Luo,
  • Quan Quan,
  • Ruimeng Yang,
  • Cong Li,
  • Jiaqi Yao,
  • Fei Tang,
  • Yisong Wang,
  • Kevin S. Zhou,
  • Jun Liu

摘要

Accurate classification of renal masses before treatment is crucial for therapeutic decision-making and patient outcome. This study developed and validated Multi-Phase Attention Network (MPANet), a multimodal deep learning model integrating multiphase contrast-enhanced CT and clinical information, which can utilize both complete-phase and missing-phase CT data for multiclass classification of four common and easily confusable renal tumors—clear cell renal cell carcinoma (ccRCC), papillary renal cell carcinoma (pRCC), oncocytic neoplasms (including chromophobe renal cell carcinoma (chRCC) and renal oncocytoma (RO)), and fat-poor angiomyolipoma (fpAML). A total of 1688 multi-center cases were enrolled. Across all test sets, MPANet consistently outperformed single-phase models. In the internal test set, MPANet achieved a macro-average AUC of 0.850, a micro-average AUC of 0.865, and an accuracy of 73.3%. These results compared favorably to assessments by four radiologists based on CT (accuracies 43.6–62.4%) and two radiologists using MRI with clear cell likelihood score (ccLS) system (accuracies 52.5% and 49.5%). The net improvement rate of MPANet over radiologist assessment ranged from 10.9% to 29.7%. In the two external test sets, macro-average AUCs were 0.811 and 0.813, and micro-average AUCs were 0.867 and 0.909, respectively. MPANet shows potential as a clinical decision-support tool for personalized renal tumor diagnosis.