Spatio-Temporal Hybrid Fusion of CAE and SWIn Transformers for Lung Cancer Malignancy Prediction

The paper proposes a novel hybrid discovery Radiomics framework that simultaneously integrates temporal and spatial features extracted from non-thin chest Computed Tomography (CT) slices to predict Lung Adenocarcinoma (LUAC) malignancy with minimum expert involvement. Lung cancer is the leading cause of mortality from cancer worldwide and has various histologic types, among which LUAC has recently been the most prevalent. LUACs are classified as pre-invasive, minimally invasive, and invasive adenocarcinomas. Timely and accurate knowledge of the lung nodules malignancy leads to a proper treatment plan and reduces the risk of unnecessary or late surgeries. Currently, chest CT scan is the primary imaging modality to assess and predict the invasiveness of LUACs. However, the radiologists' analysis based on CT images is subjective and suffers from a low accuracy compared to the ground truth pathological reviews provided after surgical resections. The proposed hybrid framework, referred to as the CAET-SWin, consists of two parallel paths: (i) The Convolutional Auto-Encoder (CAE) Transformer path that extracts and captures informative features related to inter-slice relations via a modified Transformer architecture, and; (ii) The Shifted Window (SWin) Transformer path, which is a hierarchical vision transformer that extracts nodules' related spatial features from a volumetric CT scan. Extracted temporal (from the CAET-path) and spatial (from the Swin path) are then fused through a fusion path to classify LUACs. Experimental results on our in-house dataset of 114 pathologically proven Sub-Solid Nodules (SSNs) demonstrate that the CAET-SWin significantly improves reliability of the invasiveness prediction task while achieving an accuracy of 82.65%, sensitivity of 83.66%, and specificity of 81.66% using 10-fold cross-validation.