Hu Lunyu, Xia Wei, Li Qiong, Gao Xin
School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, P. R. China.
Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu 215163, P. R. China.
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2024 Apr 25;41(2):205-212. doi: 10.7507/1001-5515.202309060.
Computed tomography (CT) imaging is a vital tool for the diagnosis and assessment of lung adenocarcinoma, and using CT images to predict the recurrence-free survival (RFS) of lung adenocarcinoma patients post-surgery is of paramount importance in tailoring postoperative treatment plans. Addressing the challenging task of accurate RFS prediction using CT images, this paper introduces an innovative approach based on self-supervised pre-training and multi-task learning. We employed a self-supervised learning strategy known as "image transformation to image restoration" to pretrain a 3D-UNet network on publicly available lung CT datasets to extract generic visual features from lung images. Subsequently, we enhanced the network's feature extraction capability through multi-task learning involving segmentation and classification tasks, guiding the network to extract image features relevant to RFS. Additionally, we designed a multi-scale feature aggregation module to comprehensively amalgamate multi-scale image features, and ultimately predicted the RFS risk score for lung adenocarcinoma with the aid of a feed-forward neural network. The predictive performance of the proposed method was assessed by ten-fold cross-validation. The results showed that the consistency index (C-index) of the proposed method for predicting RFS and the area under curve (AUC) for predicting whether recurrence occurs within three years reached 0.691 ± 0.076 and 0.707 ± 0.082, respectively, and the predictive performance was superior to that of existing methods. This study confirms that the proposed method has the potential of RFS prediction in lung adenocarcinoma patients, which is expected to provide a reliable basis for the development of individualized treatment plans.
计算机断层扫描(CT)成像对于肺腺癌的诊断和评估至关重要,利用CT图像预测肺腺癌患者术后无复发生存期(RFS)对于制定术后治疗方案至关重要。针对使用CT图像进行准确RFS预测这一具有挑战性的任务,本文介绍了一种基于自监督预训练和多任务学习的创新方法。我们采用一种名为“图像变换到图像恢复”的自监督学习策略,在公开可用的肺部CT数据集上对3D-UNet网络进行预训练,以从肺部图像中提取通用视觉特征。随后,我们通过涉及分割和分类任务的多任务学习增强网络的特征提取能力,引导网络提取与RFS相关的图像特征。此外,我们设计了一个多尺度特征聚合模块,以全面融合多尺度图像特征,并最终借助前馈神经网络预测肺腺癌的RFS风险评分。通过十折交叉验证评估了所提方法的预测性能。结果表明,所提方法预测RFS的一致性指数(C-index)以及预测三年内是否复发的曲线下面积(AUC)分别达到0.691±0.076和0.707±0.082,且预测性能优于现有方法。本研究证实所提方法在肺腺癌患者RFS预测方面具有潜力,有望为制定个体化治疗方案提供可靠依据。