# Complementary Roles of Radiomics and Foundation Representations in Renal Cell Carcinoma Classification: A Comparative Study of 2D and 3D CT Encodings

arXiv: https://arxiv.org/abs/2609.26463 · HTML: https://mlsanity.com/paper/2609.26463/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 23 of its 42 references that are in the map.
- First posted on arXiv 22 Sep 2026.

## Builds on (most cited first, 23 of 23)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Segment Anything](https://mlsanity.com/paper/2304.02643/) (2023)
- [Masked Autoencoders Are Scalable Vision Learners](https://mlsanity.com/paper/2111.06377/) (2021)
- [Grad-CAM: Visual Explanations from Deep Networks via Gradient-based Localization](https://mlsanity.com/paper/1610.02391/) (2016)
- [A Unified Approach to Interpreting Model Predictions](https://mlsanity.com/paper/1705.07874/) (2017)
- [On the Opportunities and Risks of Foundation Models](https://mlsanity.com/paper/2108.07258/) (2021)
- [Axiomatic Attribution for Deep Networks](https://mlsanity.com/paper/1703.01365/) (2017)
- [Deep Inside Convolutional Networks: Visualising Image Classification Models and Saliency Maps](https://mlsanity.com/paper/1312.6034/) (2013)
- [Towards A Rigorous Science of Interpretable Machine Learning](https://mlsanity.com/paper/1702.08608/) (2017)
- [A Survey on Deep Learning in Medical Image Analysis](https://mlsanity.com/paper/1702.05747/) (2017)
- [Sanity Checks for Saliency Maps](https://mlsanity.com/paper/1810.03292/) (2018)
- [Multimodal Machine Learning: A Survey and Taxonomy](https://mlsanity.com/paper/1705.09406/) (2017)
- [MedCLIP: Contrastive Learning from Unpaired Medical Images and Text](https://mlsanity.com/paper/2210.10163/) (2022)
- [MONAI: An open-source framework for deep learning in healthcare](https://mlsanity.com/paper/2211.02701/) (2022)
- [Med3D: Transfer Learning for 3D Medical Image Analysis](https://mlsanity.com/paper/1904.00625/) (2019)
- [Gated Multimodal Units for Information Fusion](https://mlsanity.com/paper/1702.01992/) (2017)
- [Models Genesis: Generic Autodidactic Models for 3D Medical Image Analysis](https://mlsanity.com/paper/1908.06912/) (2019)
- [Explainable artificial intelligence (XAI) in deep learning-based medical image analysis](https://mlsanity.com/paper/2107.10912/) (2021)
- [Merlin: A Computed Tomography Vision-Language Foundation Model and Dataset](https://mlsanity.com/paper/2406.06512/) (2024)
- [Image biomarker standardisation initiative](https://mlsanity.com/paper/1612.07003/) (2016)
- [MedVAE: Efficient Automated Interpretation of Medical Images with Large-Scale Generalizable Autoencoders](https://mlsanity.com/paper/2502.14753/) (2025)

## Abstract (arXiv)

Accurate preoperative subtype classification of renal cell carcinoma (RCC) from contrast-enhanced computed tomography remains clinically challenging. Radiomics provides structured tumour descriptors, whereas foundation representations offer transferable image features. However, it remains unclear whether radiomics still adds value beyond pretrained representations, and how 2D and 3D MedVAE encoders compare in this setting. We compared handcrafted radiomics, 2D MedVAE, 3D MedVAE, and their fusion for binary clear-cell RCC versus non-clear-cell RCC classification on KiTS23 under a unified preprocessing pipeline. Concatenation, cross-attention, and gated fusion were evaluated as representative integration strategies, and radiomics feature importance was analysed to support decision-centric interpretability. Fusion consistently improved discrimination over image-only MedVAE branches. The best overall performance was achieved by 3D gated fusion, with an AUC of 82.7%, outperforming the best 2D fusion model (79.6%), the radiomics baseline (74.4%), and the single-modality MedVAE branches. Ablation analysis further showed clear gains of the full fusion model over both image-only and radiomics-only variants, indicating complementary contributions from radiomics and image representations. These findings suggest that radiomics remains relevant for RCC CT classification in the presence of foundation representations, and that its integration with MedVAE is more effective in the 3D setting. More broadly, the study supports a complementary role for radiomics and foundation representations in clinically meaningful imaging decision support.