  Esophageal varices (EV), a serious health concern resulting from portal
hypertension, are traditionally diagnosed through invasive endoscopic
procedures. Despite non-contrast computed tomography (NC-CT) imaging being a
less expensive and non-invasive imaging modality, it has yet to gain full
acceptance as a primary clinical diagnostic tool for EV evaluation. To overcome
existing diagnostic challenges, we present the Multi-Organ-cOhesion-Network
(MOON), a novel framework enhancing the analysis of critical organ features in
NC-CT scans for effective assessment of EV. Drawing inspiration from the
thorough assessment practices of radiologists, MOON establishes a cohesive
multiorgan analysis model that unifies the imaging features of the related
organs of EV, namely esophagus, liver, and spleen. This integration
significantly increases the diagnostic accuracy for EV. We have compiled an
extensive NC-CT dataset of 1,255 patients diagnosed with EV, spanning three
grades of severity. Each case is corroborated by endoscopic diagnostic results.
The efficacy of MOON has been substantiated through a validation process
involving multi-fold cross-validation on 1,010 cases and an independent test on
245 cases, exhibiting superior diagnostic performance compared to methods
focusing solely on the esophagus (for classifying severe grade: AUC of 0.864
versus 0.803, and for moderate to severe grades: AUC of 0.832 versus 0.793). To
our knowledge, MOON is the first work to incorporate a synchronized multi-organ
NC-CT analysis for EV assessment, providing a more acceptable and minimally
invasive alternative for patients compared to traditional endoscopy.
