MSR-ABC: Complementary Feature Fusion for Clear Cell Renal Cell Carcinoma Classification

Yuan Liang, Sourav Bhattacharjee, Abraham Campbell

Clear cell renal cell carcinoma (ccRCC) classification from computed tomography (CT) may benefit from representations that capture different aspects of tumour phenotype. However, simply concatenating reconstruction-derived features, image--text embeddings, and radiomic descriptors may not fully exploit their complementary information. We propose MSR-ABC, a global--local framework integrating MedVAE, MedSigLIP, and radiomics. Spatially matched local image descriptors interact through cross-representation attention, while radiomic auxiliary supervision encourages the pooled local representation to retain quantitative tumour attributes. A gated residual mechanism integrates local information with global summaries. Area-aware pooling and visual and soft-text prompting complete the framework. We evaluate discrimination using a patient-level split of 396 KiTS23 cases and an external cohort of 111 TCGA/TCIA cases, reporting mean AUROC over three training seeds with 95% patient-bootstrap confidence intervals. MSR-ABC achieves mean AUROCs of 0.806 internally and 0.879 externally. Internally, it exceeds global MedVAE--radiomics and three-source concatenation by 3.35 and 3.61 AUROC…