# Improved Prognostic Prediction of Pancreatic Cancer Using Multi-Phase CT by Integrating Neural Distance and Texture-Aware Transformer

arXiv: https://arxiv.org/abs/2308.00507 · HTML: https://mlsanity.com/paper/2308.00507/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 8 of its 27 references that are in the map.
- First posted on arXiv 1 Aug 2023.

## Builds on (most cited first, 8 of 8)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [A Point Set Generation Network for 3D Object Reconstruction from a Single Image](https://mlsanity.com/paper/1612.00603/) (2016)
- [MobileViT: Light-weight, General-purpose, and Mobile-friendly Vision Transformer](https://mlsanity.com/paper/2110.02178/) (2021)
- [DeepSurv: Personalized Treatment Recommender System Using A Cox Proportional Hazards Deep Neural Network](https://mlsanity.com/paper/1606.00931/) (2016)
- [TMSS: An End-to-End Transformer-based Multimodal Network for Segmentation and Survival Prediction](https://mlsanity.com/paper/2209.05036/) (2022)
- [Devil is in the Queries: Advancing Mask Transformers for Real-world Medical Image Segmentation and Out-of-Distribution Localization](https://mlsanity.com/paper/2304.00212/) (2023)
- [Robust Pancreatic Ductal Adenocarcinoma Segmentation with Multi-Institutional Multi-Phase Partially-Annotated CT Scans](https://mlsanity.com/paper/2008.10652/) (2020)

## Built on by (most cited first, 1 of 1)

- [Multimodal Assessment of Pancreatic Cancer Resectability Using Deep Learning](https://mlsanity.com/paper/2607.13826/) (2026)

## Abstract (arXiv)

Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal cancer in which the tumor-vascular involvement greatly affects the resectability and, thus, overall survival of patients. However, current prognostic prediction methods fail to explicitly and accurately investigate relationships between the tumor and nearby important vessels. This paper proposes a novel learnable neural distance that describes the precise relationship between the tumor and vessels in CT images of different patients, adopting it as a major feature for prognosis prediction. Besides, different from existing models that used CNNs or LSTMs to exploit tumor enhancement patterns on dynamic contrast-enhanced CT imaging, we improved the extraction of dynamic tumor-related texture features in multi-phase contrast-enhanced CT by fusing local and global features using CNN and transformer modules, further enhancing the features extracted across multi-phase CT images. We extensively evaluated and compared the proposed method with existing methods in the multi-center (n=4) dataset with 1,070 patients with PDAC, and statistical analysis confirmed its clinical effectiveness in the external test set consisting of three centers. The developed risk marker was the strongest predictor of overall survival among preoperative factors and it has the potential to be combined with established clinical factors to select patients at higher risk who might benefit from neoadjuvant therapy.