# Cross-Modal Contrastive Learning from Histopathology and CT for Automated Renal Cell Carcinoma Grading

arXiv: https://arxiv.org/abs/2609.26920 · HTML: https://mlsanity.com/paper/2609.26920/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 7 of its 22 references that are in the map.
- First posted on arXiv 22 Sep 2026.

## Builds on (most cited first, 7 of 7)

- [DINOv2: Learning Robust Visual Features without Supervision](https://mlsanity.com/paper/2304.07193/) (2023)
- [TotalSegmentator: robust segmentation of 104 anatomical structures in CT images](https://mlsanity.com/paper/2208.05868/) (2022)
- [Transcriptomics-guided Slide Representation Learning in Computational Pathology](https://mlsanity.com/paper/2405.11618/) (2024)
- [Development and Evaluation of a Deep Neural Network for Histologic Classification of Renal Cell Carcinoma on Biopsy and Surgical Resection Slides](https://mlsanity.com/paper/2010.16380/) (2020)
- [Masked Pre-Training of Transformers for Histology Image Analysis](https://mlsanity.com/paper/2304.07434/) (2023)
- [Cross-Modality Learning for Predicting IHC Biomarkers from H&E-Stained Whole-Slide Images](https://mlsanity.com/paper/2506.15853/) (2025)
- [MeD-3D: A Multimodal Deep Learning Framework for Precise Recurrence Prediction in Clear Cell Renal Cell Carcinoma (ccRCC)](https://mlsanity.com/paper/2507.07839/) (2025)

## Abstract (arXiv)

Background: Clear cell renal cell carcinoma (ccRCC) exhibits substantial clinical heterogeneity, and accurate grade assessment is essential for risk stratification and treatment planning. However, conventional grading requires invasive tissue sampling. We developed RCC-Align, a cross-modal contrastive learning framework that leverages paired histopathology and computed tomography (CT) data during training to improve noninvasive CT-based ccRCC grade prediction. Methods: RCC-Align aligns paired whole-slide histopathology images (WSIs) and CT scans through contrastive cross-modal objectives, transferring grade-discriminative information from microscopic tissue morphology to macroscopic radiologic representations. The framework was trained and evaluated on paired TCGA and CPTAC cohorts using patient-level five-fold cross-validation. Performance for low- versus high-grade ccRCC classification was compared against CT-only baselines (DINOv2-Base and DINOv2-Finetuned) and a WSI-based reference model (GigaPath-Finetuned). Cross-modal alignment was assessed using cosine similarity analysis. Results: RCC-Align achieved an AUC of 0.601 (95% CI, 0.524-0.673) and AUPRC of 0.599 (95% CI, 0.541-0.676), outperforming DINOv2-Finetuned (AUC 0.545; AUPRC 0.543) with significantly improved low-grade prediction (p = 0.004). RCC-Align also demonstrated stronger paired WSI-CT embedding alignment compared with baselines. The WSI-based GigaPath reference achieved an AUC of 0.719. Conclusion: Pathology-guided contrastive learning improves CT-based ccRCC grading while requiring only CT at inference. This approach may complement tissue diagnosis when biopsy is unsafe, infeasible, or limited by intratumoral heterogeneity. Validation in larger, multi-institutional cohorts with external testing is needed before clinical translation.