# A deep local attention network for pre-operative lymph node metastasis prediction in pancreatic cancer via multiphase CT imaging

arXiv: https://arxiv.org/abs/2301.01448 · HTML: https://mlsanity.com/paper/2301.01448/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 19 of its 63 references that are in the map.
- First posted on arXiv 4 Jan 2023.

## Builds on (most cited first, 19 of 19)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Mask R-CNN](https://mlsanity.com/paper/1703.06870/) (2017)
- [Densely Connected Convolutional Networks](https://mlsanity.com/paper/1608.06993/) (2016)
- [The Kinetics Human Action Video Dataset](https://mlsanity.com/paper/1705.06950/) (2017)
- [3D U-Net: Learning Dense Volumetric Segmentation from Sparse Annotation](https://mlsanity.com/paper/1606.06650/) (2016)
- [Attention U-Net: Learning Where to Look for the Pancreas](https://mlsanity.com/paper/1804.03999/) (2018)
- [Can Spatiotemporal 3D CNNs Retrace the History of 2D CNNs and ImageNet?](https://mlsanity.com/paper/1711.09577/) (2017)
- [Tversky loss function for image segmentation using 3D fully convolutional deep networks](https://mlsanity.com/paper/1706.05721/) (2017)
- [Moments in Time Dataset: one million videos for event understanding](https://mlsanity.com/paper/1801.03150/) (2018)
- [Deep TEN: Texture Encoding Network](https://mlsanity.com/paper/1612.02844/) (2016)
- [Modified U-Net (mU-Net) with Incorporation of Object-Dependent High Level Features for Improved Liver and Liver-Tumor Segmentation in CT Images](https://mlsanity.com/paper/1911.00140/) (2019)
- [3D Graph Anatomy Geometry-Integrated Network for Pancreatic Mass Segmentation, Diagnosis, and Quantitative Patient Management](https://mlsanity.com/paper/2012.04701/) (2020)
- [Mediastinal lymph nodes segmentation using 3D convolutional neural network ensembles and anatomical priors guiding](https://mlsanity.com/paper/2102.06515/) (2021)
- [3D U2-Net: A 3D Universal U-Net for Multi-Domain Medical Image Segmentation](https://mlsanity.com/paper/1909.06012/) (2019)
- [DeepStationing: Thoracic Lymph Node Station Parsing in CT Scans using Anatomical Context Encoding and Key Organ Auto-Search](https://mlsanity.com/paper/2109.09271/) (2021)
- [Classifying a specific image region using convolutional nets with an ROI mask as input](https://mlsanity.com/paper/1812.00291/) (2018)
- [DeepPrognosis: Preoperative Prediction of Pancreatic Cancer Survival and Surgical Margin via Contrast-Enhanced CT Imaging](https://mlsanity.com/paper/2008.11853/) (2020)
- [2D and 3D CT Radiomic Features Performance Comparison in Characterization of Gastric Cancer: A Multi-center Study](https://mlsanity.com/paper/2210.16640/) (2022)

## Abstract (arXiv)

Lymph node (LN) metastasis status is one of the most critical prognostic and cancer staging factors for patients with resectable pancreatic ductal adenocarcinoma (PDAC), or in general, for any types of solid malignant tumors. Preoperative prediction of LN metastasis from non-invasive CT imaging is highly desired, as it might be straightforwardly used to guide the following neoadjuvant treatment decision and surgical planning. Most studies only capture the tumor characteristics in CT imaging to implicitly infer LN metastasis and very few work exploit direct LN's CT imaging information. To the best of our knowledge, this is the first work to propose a fully-automated LN segmentation and identification network to directly facilitate the LN metastasis status prediction task. Nevertheless LN segmentation/detection is very challenging since LN can be easily confused with other hard negative anatomic structures (e.g., vessels) from radiological images. We explore the anatomical spatial context priors of pancreatic LN locations by generating a guiding attention map from related organs and vessels to assist segmentation and infer LN status. As such, LN segmentation is impelled to focus on regions that are anatomically adjacent or plausible with respect to the specific organs and vessels. The metastasized LN identification network is trained to classify the segmented LN instances into positives or negatives by reusing the segmentation network as a pre-trained backbone and padding a new classification head. More importantly, we develop a LN metastasis status prediction network that combines the patient-wise aggregation results of LN segmentation/identification and deep imaging features extracted from the tumor region. Extensive quantitative nested five-fold cross-validation is conducted on a discovery dataset of 749 patients with PDAC.