Objectives: To develop and validate a multi-task deep learning (MTDL) model using multiphase contrast-enhanced CT (CECT) for simultaneously assessing histological subtypes, clinical stages, and anatomical complexity grades of solid malignant renal tumors. Materials and methods: This two-center retrospective study included patients with solid malignant renal tumors and their preoperative kidney CECT images. A progressive layered extraction (PLE)-based MTDL model was trained and externally tested. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC) and decision curve analysis (DCA), compared with the results of five radiologists. Results: Among 798 patients (mean age, 54 ± 12 years; 279 females; Center A: n = 620, Center B: n = 178), 597 (74.8%) had clear cell renal cell carcinomas (ccRCC), 150 (18.8%) were clinical staging III/IV, and 187 (23.4%) had high anatomical complexity. On the external test set, the MTDL model achieved AUCs of 0.89 (95% CI: 0.82, 0.94) for distinguishing ccRCC from non-ccRCC, 0.87 (95% CI: 0.81, 0.93) for clinical staging (I/II vs. III/IV), and 0.87 (95% CI: 0.82, 0.92) for anatomical complexity grading (low-intermediate vs. high). The MTDL model outperformed single-task deep learning (STDL) in clinical staging (AUC: 0.87 vs. 0.82, p = 0.022), showed higher net benefit on DCA, and demonstrated better diagnostic performance than junior radiologists in histological subtyping and clinical staging. Additionally, it used 68% less memory and was 60% faster than STDL models. Conclusion: The CECT-based MTDL model demonstrated robust performance in simultaneously predicting histological subtypes, clinical stages, and anatomical complexity grades of malignant renal tumors. Key Points: Question Accurate preoperative description of the histological subtyping, clinical staging, and anatomical complexity of malignant renal tumors is crucial for treatment decision-making . Findings By sharing features, the multi-task deep learning algorithm model enhances clinical staging performance and significantly improves computational efficiency in predicting all three tasks simultaneously . Clinical relevance The multi-task deep learning algorithm model enables rapid and accurate comprehensive preoperative evaluation of renal tumors, which assists surgeons in optimizing surgical plans and promotes the advancement of renal tumor management toward precision and efficiency .

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