One-step algorithm for fast-track localization and multi-category classification of histological subtypes in lung cancer

Accumulated evidence has proven that computer-derived features from computed tomography (CT) through radiomics and deep learning technologies can identify extensive characteristics of pulmonary malignancies, such as nodules detection and malignant lesion discrimination. However, there are few studies on whether CT images can reflect histological subtypes of lung cancer through computer-derived features.Contrast-enhanced CT images prior treatment from 417 patients diagnosed with small cell lung cancer (SCLC), lung adenocarcinoma (ADC), or lung squamous cell carcinoma (SCC) were collected. ITK-SNAP software was used by trained radiologists for the manual delineation of tumor volume. Patients of each category (SCLC, ADC, SCC) were then randomly split into training datasets and test datasets in an approximately ratio of 8:2. After image pre-processing and augmentation, 25,042 CT images from the training datasets were used to train our self-developed deep learning model for fast-tracking tumor lesions and classifying corresponding histological subtypes simultaneously. The performance of the network was evaluated by accuracy, F1-score and weighted F1-average using 1,921 testing images based on parameters generated during training.The prediction accuracy of SCLC, ADC, and SCC were 0.83, 0.75 and 0.67, respectively. The weighted F1-average was 0.75. ADC obtained the best F1-score of 0.78, which was outperformed SCLC (0.77) and SCC (0.66). The corresponding AUC values of SCLC, ADC, and SCC were 0.87, 0.84, and 0.76, respectively. Only 0.24 s were required to simultaneously achieve functions of tumor localization and histological classification on a thoracic CT image slice. The heat map visualization illustrated the extracted tumor features to classify subtypes of lung cancer by the proposed model.The newly developed multi-task algorithm provides a CNN-based DL approach in lung cancer for automatically fast-tracking tumor lesions and classifying corresponding histological subtypes in one-step.