• Yanfei Zhang, Wei Feng, Zhiyuan Wu, Weiming Li, Lixin Tao, Xiangtong Liu, Feng Zhang, Yan Gao, Jian Huang, and Xiuhua Guo.
• Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing 100069, China.
• Medicina (Kaunas). 2023 Jun 5; 59 (6).

AbstractBackground and Objectives: Lung cancer remains a leading cause of cancer mortality worldwide. Accurately classifying benign pulmonary nodules and malignant ones is crucial for early diagnosis and improved patient outcomes. The purpose of this study is to explore the deep-learning model of ResNet combined with a convolutional block attention module (CBAM) for the differentiation between benign and malignant lung cancer, based on computed tomography (CT) images, morphological features, and clinical information. Methods and materials: In this study, 8241 CT slices containing pulmonary nodules were retrospectively included. A random sample comprising 20% (n = 1647) of the images was used as the test set, and the remaining data were used as the training set. ResNet combined CBAM (ResNet-CBAM) was used to establish classifiers on the basis of images, morphological features, and clinical information. Nonsubsampled dual-tree complex contourlet transform (NSDTCT) combined with SVM classifier (NSDTCT-SVM) was used as a comparative model. Results: The AUC and the accuracy of the CBAM-ResNet model were 0.940 and 0.867, respectively, in test set when there were only images as inputs. By combining the morphological features and clinical information, CBAM-ResNet shows better performance (AUC: 0.957, accuracy: 0.898). In comparison, a radiomic analysis using NSDTCT-SVM achieved AUC and accuracy values of 0.807 and 0.779, respectively. Conclusions: Our findings demonstrate that deep-learning models, combined with additional information, can enhance the classification performance of pulmonary nodules. This model can assist clinicians in accurately diagnosing pulmonary nodules in clinical practice.

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