AUTHOR=Fu Zhizhan , Feng Fazhi , He Xingguang , Li Tongtong , Li Xiansong , Ziluo Jituome , Huang Zixing , Ye Jinlin 

TITLE=SiameseNet based on multiple instance learning for accurate identification of the histological grade of ICC tumors

JOURNAL=Frontiers in Oncology

VOLUME=Volume 15 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2025.1450379

DOI=10.3389/fonc.2025.1450379

ISSN=2234-943X

ABSTRACT=BackgroundAfter hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC) is the second most common primary liver cancer. Timely and accurate identification of ICC histological grade is critical for guiding clinical diagnosis and treatment planning.MethodWe proposed a dual-branch deep neural network (SiameseNet) based on multiple-instance learning and cross-attention mechanisms to address tumor heterogeneity in ICC histological grade prediction. The study included 424 ICC patients (381 in training, 43 in testing). The model integrated imaging data from two modalities through cross-attention, optimizing feature representation for grade classification.ResultsIn the testing cohort, the model achieved an accuracy of 86.0%, AUC of 86.2%, sensitivity of 84.6%, and specificity of 86.7%, demonstrating robust predictive performance.ConclusionThe proposed framework effectively mitigates performance degradation caused by tumor heterogeneity. Its high accuracy and generalizability suggest potential clinical utility in assisting histopathological assessment and personalized treatment planning for ICC patients.