Abstract

ObjectivesBoth radiomics and deep learning methods have shown great promise in predicting lesion malignancy in various image-based oncology studies. However, it is still unclear which method to choose for a specific clinical problem given the access to the same amount of training data. In this study, we try to compare the performance of a series of carefully selected conventional radiomics methods, end-to-end deep learning models, and deep-feature based radiomics pipelines for pulmonary nodule malignancy prediction on an open database that consists of 1297 manually delineated lung nodules.MethodsConventional radiomics analysis was conducted by extracting standard handcrafted features from target nodule images. Several end-to-end deep classifier networks, including VGG, ResNet, DenseNet, and EfficientNet were employed to identify lung nodule malignancy as well. In addition to the baseline implementations, we also investigated the importance of feature selection and class balancing, as well as separating the features learned in the nodule target region and the background/context region. By pooling the radiomics and deep features together in a hybrid feature set, we investigated the compatibility of these two sets with respect to malignancy prediction.ResultsThe best baseline conventional radiomics model, deep learning model, and deep-feature based radiomics model achieved AUROC values (mean ± standard deviations) of 0.792 ± 0.025, 0.801 ± 0.018, and 0.817 ± 0.032, respectively through 5-fold cross-validation analyses. However, after trying out several optimization techniques, such as feature selection and data balancing, as well as adding context features, the corresponding best radiomics, end-to-end deep learning, and deep-feature based models achieved AUROC values of 0.921 ± 0.010, 0.824 ± 0.021, and 0.936 ± 0.011, respectively. We achieved the best prediction accuracy from the hybrid feature set (AUROC: 0.938 ± 0.010).ConclusionThe end-to-end deep-learning model outperforms conventional radiomics out of the box without much fine-tuning. On the other hand, fine-tuning the models lead to significant improvements in the prediction performance where the conventional and deep-feature based radiomics models achieved comparable results. The hybrid radiomics method seems to be the most promising model for lung nodule malignancy prediction in this comparative study.

Highlights

  • Lung cancer is notoriously aggressive and accounts for the leading cause of cancer-related death worldwide [1]

  • This study aims to present an objective comparison among a series of carefully selected conventional radiomics methods, endto-end deep learning models, and deep-feature based radiomics pipelines for pulmonary nodule malignancy prediction on an open database that consists of 1297 manually delineated lung nodules

  • Comparing the results between the balanced (Tables 1–3) and imbalanced datasets (Tables 2–4 in Supplementary Material), one can observe that synthesizing new samples in the feature space from the minority class resulted in a remarkable improvement in classification performance

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Summary

Introduction

Lung cancer is notoriously aggressive and accounts for the leading cause of cancer-related death worldwide [1]. Most lung cancers emerge from small malignant pulmonary nodules that refer to moderately well-marginated round opacities with the largest diameter less than 3cm [4]. Most solitary pulmonary nodules have benign causes, 30%–40% of such nodules are malignant [5]. Expert radiologists visually examine the CT volumes on a slice-by-slice basis and subjectively determine the likelihood of nodule malignancy that often yields to relatively high inter/intraobserver variability of the interpretations. Highly similar visual characteristics shared among benign and malignant pulmonary nodules make this manual assessment task even more challenging (see Figure 1). It would be beneficial to develop Computer-Aided Diagnosis (CAD) tools to capture latent characteristics of the pulmonary nodules in order to assist the radiologist with the task of benign-malignant lung nodule classification

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