MAEMC-NET: a hybrid self-supervised learning method for predicting the malignancy of solitary pulmonary nodules from CT images.

Introduction: Pulmonary granulomatous nodules (PGN) often exhibit similar CT morphological features to solid lung adenocarcinomas (SLA), making preoperative differentiation challenging. This study aims to address this diagnostic challenge by developing a novel deep learning model. Methods: This study proposes MAEMC-NET, a model integrating generative (Masked AutoEncoder) and contrastive (Momentum Contrast) self-supervised learning to learn CT image representations of intra- and inter-solitary nodules. A generative self-supervised task of reconstructing masked axial CT patches containing lesions was designed to learn intra- and inter-slice image representations. Contrastive momentum is used to link the encoder in axial-CT-patch path with the momentum encoder in coronal-CT-patch path. A total of 494 patients from two centers were included. Results: MAEMC-NET achieved an area under curve (95% Confidence Interval) of 0.962 (0.934-0.973). These results not only significantly surpass the joint diagnosis by two experienced chest radiologists (77.3% accuracy) but also outperform the current state-of-the-art methods. The model performs best on medical images with a 50% mask ratio, showing a 1.4% increase in accuracy compared to the optimal 75% mask ratio on natural images. Discussion: The proposed MAEMC-NET effectively distinguishes between benign and malignant solitary pulmonary nodules and holds significant potential to assist radiologists in improving the diagnostic accuracy of PGN and SLA.