arXiv:2511.19478eess.IVcs.CV2025-11

用多阶段深度学习+新数据增强法,非侵入诊断儿童肝肿瘤良恶性。

A Multi-Stage Deep Learning Framework with PKCP-MixUp Augmentation for Pediatric Liver Tumor Diagnosis Using Multi-Phase Contrast-Enhanced CT

  • 分阶段处理:先检测肿瘤,再分类良恶性与亚型,提升准确性。
  • 良恶性分类AUC达0.989,亚型分类最高AUC达0.979,表现优异。
  • 针对儿童肝癌数据少、难标注问题,提出新颖混合增强方法。

儿童肝肿瘤是儿科最常见的实体肿瘤之一,良恶性区分及病理分型对临床治疗至关重要。尽管病理检查为金标准,但侵入性活检存在显著局限:儿童肝脏血管丰富、肿瘤组织脆弱,易引发出血等并发症;且年幼儿童依从性差,需麻醉下操作,增加医疗成本与心理创伤。尽管已有诸多人工智能应用尝试,但针对儿童肝肿瘤的研究仍被忽视。为此,我们构建了一种基于多期增强CT的多阶段深度学习框架,实现儿童肝肿瘤的自动化诊断。纳入两组回顾性与前瞻性队列。提出新型PKCP-MixUp数据增强方法以缓解数据稀缺与类别不平衡问题。训练肿瘤检测模型提取感兴趣区域(ROI),随后采用三骨干双阶段诊断流程,基于掩码图像进行分类。肿瘤检测模型表现优异(mAP=0.871),良恶性分类第一阶段模型达到优秀性能(AUC=0.989)。最终诊断模型亦具鲁棒性,良性亚型分类AUC=0.915,恶性亚型分类AUC=0.979。进一步开展多层次对比分析,包括消融实验、可解释性分析(Shapley值与CAM)等。本框架填补了儿童专属深度学习诊断空白,为CT扫描时机选择与模型设计提供可行动洞察,推动精准、可及的儿童肝肿瘤诊断发展。

原文摘要 · Abstract (English)

Pediatric liver tumors are one of the most common solid tumors in pediatrics, with differentiation of benign or malignant status and pathological classification critical for clinical treatment. While pathological examination is the gold standard, the invasive biopsy has notable limitations: the highly vascular pediatric liver and fragile tumor tissue raise complication risks such as bleeding; additionally, young children with poor compliance require anesthesia for biopsy, increasing medical costs or psychological trauma. Although many efforts have been made to utilize AI in clinical settings, most researchers have overlooked its importance in pediatric liver tumors. To establish a non-invasive examination procedure, we developed a multi-stage deep learning (DL) framework for automated pediatric liver tumor diagnosis using multi-phase contrast-enhanced CT. Two retrospective and prospective cohorts were enrolled. We established a novel PKCP-MixUp data augmentation method to address data scarcity and class imbalance. We also trained a tumor detection model to extract ROIs, and then set a two-stage diagnosis pipeline with three backbones with ROI-masked images. Our tumor detection model has achieved high performance (mAP=0.871), and the first stage classification model between benign and malignant tumors reached an excellent performance (AUC=0.989). Final diagnosis models also exhibited robustness, including benign subtype classification (AUC=0.915) and malignant subtype classification (AUC=0.979). We also conducted multi-level comparative analyses, such as ablation studies on data and training pipelines, as well as Shapley-Value and CAM interpretability analyses. This framework fills the pediatric-specific DL diagnostic gap, provides actionable insights for CT phase selection and model design, and paves the way for precise, accessible pediatric liver tumor diagnosis.

医学影像深度学习儿童肿瘤CT诊断

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