Multimodal Assessment of Pancreatic Cancer Resectability Using Deep Learning

Vincent Ochs, Christoph Kuemmerli, Florentin Bieder, Julia Wolleb, Joel L. Lavanchy, Julia Ruppel, Jan Liechti, Stephanie Taha-Mehlitz, Christian Andreas Nebiker, Beat Mueller, Giuseppe Kito Fusai, Joerg-Matthias Pollok, Anas Taha, Philippe C. Cattin, Sebastian Staubli

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.