Performing Automatic Identification and Staging of Urothelial Carcinoma in Bladder Cancer Patients Using a Hybrid Deep-Machine Learning Approach

SIMPLE SUMMARY: Early and accurate bladder cancer staging is important as it determines the mode of initial treatment. Non-muscle invasive bladder cancer (NMIBC) can be treated with transurethral resection whereas muscle invasive bladder cancer (MIBC) requires neoadjuvant chemotherapy with subsequent cystectomy as indicated. Our hybrid machine/deep learning model demonstrates improved accuracy of bladder cancer staging by CECT using a hybrid machine/deep learning model which will facilitate appropriate clinical management of the patients with bladder cancer, ultimately improving patient outcome. ABSTRACT: Accurate clinical staging of bladder cancer aids in optimizing the process of clinical decision-making, thereby tailoring the effective treatment and management of patients. While several radiomics approaches have been developed to facilitate the process of clinical diagnosis and staging of bladder cancer using grayscale computed tomography (CT) scans, the performances of these models have been low, with little validation and no clear consensus on specific imaging signatures. We propose a hybrid framework comprising pre-trained deep neural networks for feature extraction, in combination with statistical machine learning techniques for classification, which is capable of performing the following classification tasks: (1) bladder cancer tissue vs. normal tissue, (2) muscle-invasive bladder cancer (MIBC) vs. non-muscle-invasive bladder cancer (NMIBC), and (3) post-treatment changes (PTC) vs. MIBC.