An Attention-Based Deep Learning Network for Predicting Platinum Resistance in Ovarian Cancer

Ovarian cancer is one of the three most common types of gynecological cancer globally, with high-grade serous ovarian cancer being the most common and aggressive histological type. Guided treatment of high-grade serous ovarian cancer typically involves platinum-based combination chemotherapy, necessitating the assessment of whether the patient is platinum resistant. This study proposes a deep learning-based method to determine whether a patient is platinum resistant using multimodal positron emission tomography/computed tomography images. In total, 289 patients with high-grade serous ovarian cancer were included in this study. An end-to-end Squeeze-Excitation-Spatial Pyramid Pooling-Dense Convolutional Network model was built by adding a Squeeze-Excitation Block and Spatial Pyramid Pooling Layer to a Dense Convolutional Network. Multimodal data from positron emission tomography/computed tomography images of regions of interest were used to predict platinum resistance in patients. Through five-fold cross-validation, the Squeeze-Excitation-Spatial Pyramid Pooling-Dense Convolutional Network achieved a high accuracy rate and area under the curve of 92.6% and 0.93, respectively, for predicting platinum resistance in patients. The importance of incorporating the Squeeze-Excitation Block and Spatial Pyramid Pooling Layer into the deep learning model and considering multimodal data was substantiated by performing ablation studies and experiments with single-modality data. The classification results indicate that our proposed deep learning framework performs better in predicting platinum resistance in patients, which can help gynecologists make more appropriate treatment decisions.