text: Traditional survival models such as the Cox proportional hazards model are typically based on scalar or categorical clinical features. With the advent of increasingly large image datasets, it has become feasible to incorporate quantitative image features into survival prediction. So far, this kind of analysis is mostly based on radiomics features, i.e. a fixed set of features that is mathematically defined a priori. To capture highly abstract information, it is desirable to learn the feature extraction using convolutional neural networks. However, for tomographic medical images, model training is difficult because on the one hand, only few samples of 3D image data fit into one batch at once and on the other hand, survival loss functions are essentially ordering measures that require large batch sizes. In this work, we show that by simplifying survival analysis to median survival classification, convolutional neural networks can be trained with small batch sizes and learn features that predict survival equally well as end-to-end hazard prediction networks. Our approach outperforms the previous state of the art in a publicly available lung cancer dataset.
  @cite_3: Human cancers exhibit strong phenotypic differences that can be visualized noninvasively by medical imaging. Radiomics refers to the comprehensive quantification of tumour phenotypes by applying a large number of quantitative image features. Here we present a radiomic analysis of 440 features quantifying tumour image intensity, shape and texture, which are extracted from computed tomography data of 1,019 patients with lung or head-and-neck cancer. We find that a large number of radiomic features have prognostic power in independent data sets of lung and head-and-neck cancer patients, many of which were not identified as significant before. Radiogenomics analysis reveals that a prognostic radiomic signature, capturing intratumour heterogeneity, is associated with underlying gene-expression patterns. These data suggest that radiomics identifies a general prognostic phenotype existing in both lung and head-and-neck cancer. This may have a clinical impact as imaging is routinely used in clinical practice, providing an unprecedented opportunity to improve decision-support in cancer treatment at low cost.
summary: We aim to address this issue by transferring features learned by a classification problem to survival analysis without losing performance. Moreover, we propose a method to combine radiomics and learned CNN features that enforce the CNN to learn features that are both discriminative and not covered by the radiomics feature set. All methods are evaluated on a publicly available dataset of computed tomography (CT) images of non-small-cell lung cancer (NSCLC) patients and corresponding survival labels. We show that our method can outperform the previous state-of-the-art presented in @cite_3 .