Yuan Liang, Sourav Bhattacharjee, Abraham Campbell
原文摘要
Clear cell renal cell carcinoma (ccRCC) is the most common kidney cancer in adults. We present a region-aware architecture for CT-based ccRCC classification. Tumor and 0--10 mm peritumoral context are pooled separately from shared frozen DINOv3 feature maps. A shared position-aware slice aggregator precedes fixed training-only principal component analysis (PCA). The resulting representations are fused with radiomics using two scalar feature gates. Evaluation on KiTS23 and 111 external cases yields internal test and external AUCs of 0.8078\pm0.0154 and 0.9094\pm0.0015. Compared with matched single-tumor readout, mean AUC increases by 1.50 and 2.34 percentage points, respectively. Early-PCA and reconstruction controls yield lower internal mean AUCs, while external AUC is similar for early and late PCA. These findings highlight the joint role of regional readout and slice aggregation in adapting frozen visual features to renal CT.
Yuan Liang, Sourav Bhattacharjee, Abraham Campbell
原文摘要
Clear cell renal cell carcinoma (ccRCC) classification from computed tomography (CT) may benefit from representations that capture different aspects of tumour phenotype. However, simply concatenating reconstruction-derived features, image--text embeddings, and radiomic descriptors may not fully exploit their complementary information. We propose MSR-ABC, a global--local framework integrating MedVAE, MedSigLIP, and radiomics. Spatially matched local image descriptors interact through cross-representation attention, while radiomic auxiliary supervision encourages the pooled local representation to retain quantitative tumour attributes. A gated residual mechanism integrates local information with global summaries. Area-aware pooling and visual and soft-text prompting complete the framework. We evaluate discrimination using a patient-level split of 396 KiTS23 cases and an external cohort of 111 TCGA/TCIA cases, reporting mean AUROC over three training seeds with 95% patient-bootstrap confidence intervals. MSR-ABC achieves mean AUROCs of 0.806 internally and 0.879 externally. Internally, it exceeds global MedVAE--radiomics and three-source concatenation by 3.35 and 3.61 AUROC percentage points, respectively. Removing any source lowers mean AUROC in both cohorts, with the largest decreases following radiomics removal. Individual removal of cross-representation attention, auxiliary supervision, or gated fusion also lowers internal mean AUROC. These findings are consistent with complementary contributions within the integrated architecture and support further investigation of structured representation fusion for non-invasive renal tumour characterisation.