{"id":"https://openalex.org/W7225817344","doi":"https://doi.org/10.21203/rs.3.rs-11302345/v1","title":"A Lesion-Guided Deep Learning Framework for Differential Diagnosis of Pulmonary Nodules: A Pathology-Confirmed Study of Pulmonary Tuberculosis, Lung Cancer, Pulmonary Cryptococcosis, and Other Granulomatous Lung Lesions","display_name":"A Lesion-Guided Deep Learning Framework for Differential Diagnosis of Pulmonary Nodules: A Pathology-Confirmed Study of Pulmonary Tuberculosis, Lung Cancer, Pulmonary Cryptococcosis, and Other Granulomatous Lung Lesions","publication_year":2026,"publication_date":"2026-11-11","ids":{"openalex":"https://openalex.org/W7225817344","doi":"https://doi.org/10.21203/rs.3.rs-11302345/v1"},"language":"en","primary_location":{"id":"doi:10.21203/rs.3.rs-11302345/v1","doi":"https://doi.org/10.21203/rs.3.rs-11302345/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-11302345/v1","pdf_url":null,"source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://doi.org/10.21203/rs.3.rs-11302345/v1","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5101728492","display_name":"Ying Hu","orcid":"https://orcid.org/0000-0002-5115-9420","observed_orcids":["https://orcid.org/0000-0002-5115-9420"]},"institutions":[{"id":"https://openalex.org/I4210166576","display_name":"First Affiliated Hospital Zhejiang University","ror":"https://ror.org/05m1p5x56","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210166576"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Ying Hu","raw_affiliation_strings":["First Affiliated Hospital Zhejiang University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"First Affiliated Hospital Zhejiang University","institution_ids":["https://openalex.org/I4210166576"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5112982067","display_name":"Chensong Xu","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210166576","display_name":"First Affiliated Hospital Zhejiang University","ror":"https://ror.org/05m1p5x56","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210166576"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Chensong Xu","raw_affiliation_strings":["First Affiliated Hospital Zhejiang University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"First Affiliated Hospital Zhejiang University","institution_ids":["https://openalex.org/I4210166576"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5104047649","display_name":"Sijie Qian","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210166576","display_name":"First Affiliated Hospital Zhejiang University","ror":"https://ror.org/05m1p5x56","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210166576"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Sijie Qian","raw_affiliation_strings":["First Affiliated Hospital Zhejiang University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"First Affiliated Hospital Zhejiang University","institution_ids":["https://openalex.org/I4210166576"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161056712","display_name":"Tingwei Xu","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210166576","display_name":"First Affiliated Hospital Zhejiang University","ror":"https://ror.org/05m1p5x56","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210166576"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Tingwei Xu","raw_affiliation_strings":["First Affiliated Hospital Zhejiang University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"First Affiliated Hospital Zhejiang University","institution_ids":["https://openalex.org/I4210166576"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161440378","display_name":"Xukun Li","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Xukun Li","raw_affiliation_strings":["Hangzhou AiSmartVision Co., Ltd"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Hangzhou AiSmartVision Co., Ltd","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5016286647","display_name":"Weibo Du","orcid":"https://orcid.org/0000-0001-5779-6159","observed_orcids":["https://orcid.org/0000-0001-5779-6159"]},"institutions":[{"id":"https://openalex.org/I4210166576","display_name":"First Affiliated Hospital Zhejiang University","ror":"https://ror.org/05m1p5x56","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210166576"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Weibo Du","raw_affiliation_strings":["First Affiliated Hospital Zhejiang University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"First Affiliated Hospital Zhejiang University","institution_ids":["https://openalex.org/I4210166576"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5161477307","display_name":"Wei Wu","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210166576","display_name":"First Affiliated Hospital Zhejiang University","ror":"https://ror.org/05m1p5x56","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210166576"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Wei Wu","raw_affiliation_strings":["First Affiliated Hospital Zhejiang University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"First Affiliated Hospital Zhejiang University","institution_ids":["https://openalex.org/I4210166576"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10862","display_name":"AI in cancer detection","score":0.7583000063896179,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},"topics":[{"id":"https://openalex.org/T10862","display_name":"AI in cancer detection","score":0.7583000063896179,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T12422","display_name":"Radiomics and Machine Learning in Medical Imaging","score":0.14010000228881836,"subfield":{"id":"https://openalex.org/subfields/2741","display_name":"Radiology, Nuclear Medicine and Imaging"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10202","display_name":"Lung Cancer Diagnosis and Treatment","score":0.08219999819993973,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8762000203132629},{"id":"https://openalex.org/C2777714996","wikidata":"https://www.wikidata.org/wiki/Q7886","display_name":"Lung","level":2,"score":0.6543999910354614},{"id":"https://openalex.org/C2780801072","wikidata":"https://www.wikidata.org/wiki/Q837512","display_name":"Differential diagnosis","level":2,"score":0.6333000063896179},{"id":"https://openalex.org/C2908628106","wikidata":"https://www.wikidata.org/wiki/Q12204","display_name":"Pulmonary tuberculosis","level":3,"score":0.6026999950408936},{"id":"https://openalex.org/C126838900","wikidata":"https://www.wikidata.org/wiki/Q77604","display_name":"Radiology","level":1,"score":0.5870000123977661},{"id":"https://openalex.org/C2781156865","wikidata":"https://www.wikidata.org/wiki/Q827023","display_name":"Lesion","level":2,"score":0.37880000472068787},{"id":"https://openalex.org/C2781301800","wikidata":"https://www.wikidata.org/wiki/Q193894","display_name":"Sarcoidosis","level":2,"score":0.35019999742507935},{"id":"https://openalex.org/C108583219","wikidata":"https://www.wikidata.org/wiki/Q197536","display_name":"Deep learning","level":2,"score":0.34619998931884766},{"id":"https://openalex.org/C2780244788","wikidata":"https://www.wikidata.org/wiki/Q1877474","display_name":"Solitary pulmonary nodule","level":3,"score":0.3386000096797943},{"id":"https://openalex.org/C2781069245","wikidata":"https://www.wikidata.org/wiki/Q12204","display_name":"Tuberculosis","level":2,"score":0.33730000257492065},{"id":"https://openalex.org/C36454342","wikidata":"https://www.wikidata.org/wiki/Q245341","display_name":"Radiography","level":2,"score":0.2973000109195709},{"id":"https://openalex.org/C66905080","wikidata":"https://www.wikidata.org/wiki/Q17005494","display_name":"Binary classification","level":3,"score":0.2793999910354614},{"id":"https://openalex.org/C2776265017","wikidata":"https://www.wikidata.org/wiki/Q220570","display_name":"Pulmonary embolism","level":2,"score":0.2628999948501587},{"id":"https://openalex.org/C2780140890","wikidata":"https://www.wikidata.org/wiki/Q1129338","display_name":"Granuloma","level":2,"score":0.26179999113082886},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.25929999351501465},{"id":"https://openalex.org/C142724271","wikidata":"https://www.wikidata.org/wiki/Q7208","display_name":"Pathology","level":1,"score":0.2515999972820282}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.21203/rs.3.rs-11302345/v1","doi":"https://doi.org/10.21203/rs.3.rs-11302345/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-11302345/v1","pdf_url":null,"source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.21203/rs.3.rs-11302345/v1","doi":"https://doi.org/10.21203/rs.3.rs-11302345/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-11302345/v1","pdf_url":null,"source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"},"sustainable_development_goals":[],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":24,"referenced_works":["https://openalex.org/W2075620628","https://openalex.org/W2128739912","https://openalex.org/W2608231518","https://openalex.org/W2751596576","https://openalex.org/W2803187109","https://openalex.org/W2904258904","https://openalex.org/W2940711273","https://openalex.org/W2946185430","https://openalex.org/W2949942603","https://openalex.org/W2963488165","https://openalex.org/W3018853963","https://openalex.org/W3080199224","https://openalex.org/W3097970322","https://openalex.org/W3111045851","https://openalex.org/W3129053565","https://openalex.org/W3136991990","https://openalex.org/W4283118752","https://openalex.org/W4290647502","https://openalex.org/W4311515036","https://openalex.org/W4375928970","https://openalex.org/W4390685692","https://openalex.org/W4400494969","https://openalex.org/W4402680950","https://openalex.org/W4408842128"],"related_works":[],"abstract_inverted_index":{"Abstract":[0],"Background":[1],"Pulmonary":[2],"tuberculous":[3],"nodules":[4,50,224],"frequently":[5],"exhibit":[6],"imaging":[7,204],"features":[8],"that":[9,98,196],"overlap":[10],"with":[11,62,113,160],"those":[12],"of":[13,46,146,163,168,191,213],"lung":[14,86,216],"cancer,":[15,217],"pulmonary":[16,49,65,68,73,155,158,176,178,214,218,223],"cryptococcosis,":[17,159,179,219],"and":[18,27,85,103,122,165,180,210,220,244],"other":[19,78,181,221],"granulomatous":[20,79,182,222],"lesions,":[21,184],"making":[22],"accurate":[23,209],"preoperative":[24,237],"diagnosis":[25,45],"challenging":[26],"often":[28],"resulting":[29],"in":[30,105,153],"unnecessary":[31,246],"surgical":[32,247],"intervention.":[33,248],"We":[34,91],"developed":[35,92],"a":[36,93,188],"lesion-guided":[37,94],"deep":[38,116],"learning":[39,117],"framework":[40,231],"to":[41,235],"improve":[42,236],"the":[43,130,141,171,185,233],"differential":[44],"surgically":[47,63],"resected":[48],"on":[51],"chest":[52,226],"CT.":[53],"Methods":[54],"This":[55],"single-center":[56],"retrospective":[57],"study":[58],"included":[59],"1,084":[60],"patients":[61],"confirmed":[64],"nodules,":[66],"comprising":[67],"tuberculosis":[69,156],"(n":[70,75,82,88],"=":[71,76,83,89],"240),":[72],"cryptococcosis":[74],"298),":[77],"inflammatory":[80,183],"lesions":[81],"252),":[84],"malignancies":[87],"294).":[90],"dual-branch":[95],"UNet":[96],"(LG-DU-Net)":[97],"jointly":[99],"performed":[100],"lesion":[101],"segmentation":[102],"classification":[104,124,136,173],"an":[106,144,161,166],"end-to-end":[107],"framework.":[108],"Model":[109],"performance":[110,133,150],"was":[111,151],"compared":[112],"five":[114],"representative":[115],"models":[118],"using":[119,225],"multiple":[120],"binary":[121],"multi-class":[123],"tasks.":[125,137],"Results":[126],"LG-DU-Net":[127,207],"consistently":[128],"achieved":[129,143,187],"best":[131],"diagnostic":[132,238],"across":[134],"all":[135],"In":[138,170],"benign\u2013malignant":[139],"classification,":[140],"model":[142,186,197],"AUC":[145,162,190],"0.880.":[147],"The":[148,229],"highest":[149],"observed":[152],"differentiating":[154],"from":[157],"0.972":[164],"accuracy":[167],"89.8%.":[169],"three-class":[172],"task":[174],"involving":[175],"tuberculosis,":[177,215],"macro-average":[189],"0.862.":[192],"Grad-CAM":[193],"visualization":[194],"demonstrated":[195],"predictions":[198],"were":[199],"primarily":[200],"driven":[201],"by":[202],"lesion-related":[203],"features.":[205],"Conclusion":[206],"enables":[208],"interpretable":[211],"differentiation":[212],"CT":[227],"images.":[228],"proposed":[230],"has":[232],"potential":[234],"accuracy,":[239],"facilitate":[240],"appropriate":[241],"clinical":[242],"management,":[243],"reduce":[245]},"counts_by_year":[],"updated_date":"2026-11-12T12:28:57.059296","created_date":"2026-11-12T00:00:00"}