From Global Radiomics to Parametric Maps: A Unified Workflow Fusing Radiomics and Deep Learning for PDAC Detection

Accurate determination of pancreatic ductal adenocarcinoma (PDAC) resectability relies on evaluating how the tumor interacts with major peripancreatic vessels on CT imaging, yet expert assessment often shows substantial variability. We introduce a fully automated multimodal deep learning framework that jointly analyzes 3D contrast enhanced CT and structured clinical information to classify patients into the three National Comprehensive Cancer Network (NCCN) resectability categories (upfront resectable, borderline resectable, locally advanced). The approach uses a Swin-UNETR backbone to obtain anatomy aware image representations through auxiliary segmentation of pancreas, tumor, and vascular structures. These features are fused with a compact clinical embedding derived from 17 routinely collected variables and processed by a lightweight classification head. Model training is guided by a dynamic multitask objective that adapts the balance between segmentation and classification based on current tumor Dice performance, promoting feature representations that remain both anatomically informed and discriminative.

Survival research in pancreatic ductal adenocarcinoma (PDAC) is limited by the scarcity of datasets linking whole-slide histology with clinical, molecular, and long-term outcome data. We present a retrospective single-centre cohort of 302 patients who underwent PDAC resection at University Medical Center Gottingen. The dataset comprises 446 H&E whole-slide images, clinicopathological variables, targeted sequencing data for 154 patients, and overall-survival outcomes. During follow-up, 253 patients died, and the median follow-up was 76 months. To establish initial reference values, we evaluated fourteen survival-prediction configurations using identical five-repetition Monte Carlo cross-validation partitions. Ridge Cox regression using numeric clinicopathological variables achieved a mean concordance of $0.649 \pm 0.042$ and $0.652 \pm 0.046$ after adding KRAS and TP53 mutation status. The image-only attention model achieved $0.603 \pm 0.030$, while multimodal fusion achieved $0.619 \pm 0.025$, the highest concordance among the neural models. These results establish promising initial benchmarks for future research using this pancreas-specific multimodal dataset, paving the way for external validation.

Deep learning has achieved remarkable performance in medical image segmentation, yet it suffers from critical limitations: mathematical intractability, substantial parameter requirements, and lack of clinical interpretability. We propose RadiomicNet, a novel two-stream hybrid architecture that enhances standard deep learning by integrating handcrafted radiomics features directly into the segmentation learning process. The key contribution is the Radiomics Attention Gate (RAG), which leverages Gray-Level Co-occurrence Matrix (GLCM) and Local Binary Pattern (LBP) features to modulate skip-connection attention in a lightweight MobileNetV2-based encoder-decoder, providing ante-hoc interpretability without post-hoc approximations. A novel Radiomics Consistency Loss further enforces alignment between texture complexity and prediction uncertainty, reducing Expected Calibration Error (ECE) from 0.142 to 0.118. RadiomicNet achieves a Dice Similarity Coefficient (DSC) of 0.763 +/- 0.231 on the Breast Ultrasound Images (BUSI) dataset and 0.854 +/- 0.112 on Kvasir-SEG, outperforming U-KAN by 1.2% and 1.8%, respectively (p < 0.05, Wilcoxon signed-rank test), with only 3.27M parameters, 9.5x fewer than standard U-Net and 4.3x fewer than U-KAN. Gradient-based feature importance analysis reveals that GLCM dissimilarity (15.24%), GLCM energy (14.56%), and LBP entropy (11.49%) are the dominant radiomics cues, providing clinically meaningful explanations for segmentation decisions. The proposed approach demonstrates that compact, interpretable models grounded in domain knowledge can deliver state-of-the-art segmentation performance with substantially reduced computational overhead.