MLDRL: Multi-loss disentangled representation learning for predicting esophageal cancer response to neoadjuvant chemoradiotherapy using longitudinal CT images.

Accurate prediction of pathological complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) is essential for clinical precision treatment. However, the existing methods of predicting pCR in esophageal cancer are based on the single stage data, which limits the performance of these methods. Effective fusion of the longitudinal data has the potential to improve the performance of pCR prediction, thanks to the combination of complementary information. In this study, we propose a new multi-loss disentangled representation learning (MLDRL) to realize the effective fusion of complementary information in the longitudinal data. Specifically, we first disentangle the latent variables of features in each stage into inherent and variational components. Then, we define a multi-loss function to ensure the effectiveness and structure of disentanglement, which consists of a cross-cycle reconstruction loss, an inherent-variational loss and a supervised classification loss. Finally, an adaptive gradient normalization algorithm is applied to balance the training of multiple loss terms by dynamically tuning the gradient magnitudes. Due to the cooperation of the multi-loss function and the adaptive gradient normalization algorithm, MLDRL effectively restrains the potential interference and achieves effective information fusion. The proposed method is evaluated on multi-center datasets, and the experimental results show that our method not only outperforms several state-of-art methods in pCR prediction, but also achieves better performance in the prognostic analysis of multi-center unlabeled datasets.