Res-TransNet: A Hybrid deep Learning Network for Predicting Pathological Subtypes of lung Adenocarcinoma in CT Images

This study aims to develop a CT-based hybrid deep learning network to predict pathological subtypes of early-stage lung adenocarcinoma by integrating residual network (ResNet) with Vision Transformer (ViT). A total of 1411 pathologically confirmed ground-glass nodules (GGNs) retrospectively collected from two centers were used as internal and external validation sets for model development. 3D ResNet and ViT were applied to investigate two deep learning frameworks to classify three subtypes of lung adenocarcinoma namely invasive adenocarcinoma (IAC), minimally invasive adenocarcinoma and adenocarcinoma in situ, respectively. To further improve the model performance, four Res-TransNet based models were proposed by integrating ResNet and ViT with different ensemble learning strategies. Two classification tasks involving predicting IAC from Non-IAC (Task1) and classifying three subtypes (Task2) were designed and conducted in this study. For Task 1, the optimal Res-TransNet model yielded area under the receiver operating characteristic curve (AUC) values of 0.986 and 0.933 on internal and external validation sets, which were significantly higher than that of ResNet and ViT models (p < 0.05). For Task 2, the optimal fusion model generated the accuracy and weighted F1 score of 68.3% and 66.1% on the external validation set. The experimental results demonstrate that Res-TransNet can significantly increase the classification performance compared with the two basic models and have the potential to assist radiologists in precision diagnosis.