An endoscopic ultrasound-based interpretable deep learning model and nomogram for distinguishing pancreatic neuroendocrine tumors from pancreatic cancer

作者：Yi Nan, Shuangyang Mo, Yan Zhang, Qi Jiang, Yingwei Wang, Cheng Huang, Shanyu Qin, Haixing Jiang · 发表于：Scientific Reports · 年份：2025 · DOI：10.1038/s41598-024-84749-7 · 被引用次数：11 · 研究领域：Pancreatic and Hepatic Oncology Research、Neuroendocrine Tumor Research Advances、Radiomics and Machine Learning in Medical Imaging

To retrospectively develop and validate an interpretable deep learning model and nomogram utilizing endoscopic ultrasound (EUS) images to predict pancreatic neuroendocrine tumors (PNETs). Following confirmation via pathological examination, a retrospective analysis was performed on a cohort of 266 patients, comprising 115 individuals diagnosed with PNETs and 151 with pancreatic cancer. These patients were randomly assigned to the training or test group in a 7:3 ratio. The least absolute shrinkage and selection operator algorithm was employed to reduce the dimensionality of deep learning (DL) features extracted from pre-standardized EUS images. The retained nonzero coefficient features were subsequently applied to develop predictive eight DL models based on distinct machine learning algorithms. The optimal DL model was identified and used to establish a clinical signature, which subsequently informed the construction and evaluation of a nomogram. Gradient-weighted Class Activation Mapping (Grad-CAM) and Shapley Additive Explanations (SHAP) were implemented to interpret and visualize the model outputs. A total of 2048 DL features were initially extracted, from which only 27 features with coefficients greater than zero were retained. The support vector machine (SVM) DL model demonstrated exceptional performance, achieving area under the curve (AUC) values of 0.948 and 0.795 in the training and test groups, respectively. Additionally, a nomogram was developed, incorporating both ...