ArticleCurrent medical imaging2026
Deep Learning and Attention Mechanism-based Prediction of Vaginal Invasion in Early-Stage Cervical Cancer
Article in Current medical imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionThis study introduces a novel fusion of 3D ResNet classification and Grad-CAM visualization to predict vaginal invasion in early-stage cervical cancer using T2WI-MRI, enhancing diagnostic accuracy while enabling anatomical localization of invasive lesions.
methodsThis retrospective study analyzed sagittal T2WI from 160 patients with pathologically confirmed stage IB-IIA cervical cancer to predict vaginal invasion. Following an 8:2 training-test split, radiomic features were extracted from manually delineated intratumoral regions and four concentrically expanded peritumoral regions (1-4mm). Features selection by Pearson correlation and LASSO regression. Random forest models incorporating intratumoral and peritumoral (0-4mm) features were constructed, with ROC analysis identifying the optimal model. Subsequently, a 3D-ResNet architecture, enhanced with anisotropic convolutional layers and sophisticated data augmentation, was developed and optimized using the optimal ROI configuration. Model interpretability was facilitated using Grad-CAM, with performance assessed by AUC, sensitivity, specificity, accuracy, and precision.
resultsThe AIC-enhanced 3D ResNet-18 model, integrating intratumoral and 3mm peritumoral regions, showed superior test performance (AUC: 0.784, Sensitivity: 0.650, Specificity: 0.765, Accuracy: 0.611, Precision: 0.686) versus the baseline (AUC: 0.742), representing a 6% AUC improvement. Grad-CAM heatmaps identified diagnostically relevant regions within the tumor microenvironment, enhancing biological plausibility and model interpretability. DISCUSSION: This attention-integrated 3D ResNet-18 framework (AUC=0.784) facilitates non-invasive vaginal invasion detection for fertility-sparing decisions, validated through Grad-CAM tumor localization; however, derivation from a single-center cohort warrants external validation and prospective studies before clinical translation.
conclusionThis preliminary study demonstrates promising deep learning performance (3D ResNet-18+Grad-CAM+AIC) for vaginal invasion assessment, despite moderate n; however, a single-center retrospective design limits generalizability.
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