School of Computer Science and Engineering, Beihang University, Beijing 100191, People's Republic of China.
Beijing Advanced Innovation Center for Big Data and Brain Computing, Beihang University, Beijing 100191, People's Republic of China.
Phys Med Biol. 2022 Jun 29;67(13). doi: 10.1088/1361-6560/ac6e25.
Glioblastoma (GBM) is a severe malignant brain tumor with bad prognosis, and overall survival (OS) time prediction is of great clinical value for customized treatment. Recently, many deep learning (DL) based methods have been proposed, and most of them build deep networks to directly map pre-operative images of patients to the OS time. However, such end-to-end prediction is sensitive to data inconsistency and noise. In this paper, inspired by the fact that clinicians usually evaluate patient prognosis according to previously encountered similar cases, we propose a novel multimodal deep KNN based OS time prediction method. Specifically, instead of the end-to-end prediction, for each input patient, our method first search itsnearest patients with known OS time in a learned metric space, and the final OS time of the input patient is jointly determined by thenearest patients, which is robust to data inconsistency and noise. Moreover, to take advantage of multiple imaging modalities, a new inter-modality loss is introduced to encourage learning complementary features from different modalities. The in-house single-center dataset containing multimodal MR brain images of 78 GBM patients is used to evaluate our method. In addition, to demonstrate that our method is not limited to GBM, a public multi-center dataset (BRATS2019) containing 211 patients with low and high grade gliomas is also used in our experiment. As benefiting from the deep KNN and the inter-modality loss, our method outperforms all methods under evaluation in both datasets. To the best of our knowledge, this is the first work, which predicts the OS time of GBM patients in the strategy of KNN under the DL framework.
胶质母细胞瘤(GBM)是一种预后不良的严重恶性脑肿瘤,总体生存(OS)时间预测对定制治疗具有重要的临床价值。最近,已经提出了许多基于深度学习(DL)的方法,其中大多数方法构建深度网络,直接将患者的术前图像映射到 OS 时间。然而,这种端到端的预测对数据不一致性和噪声很敏感。在本文中,受临床医生通常根据先前遇到的类似病例评估患者预后的事实启发,我们提出了一种新颖的基于多模态深度 KNN 的 OS 时间预测方法。具体来说,对于每个输入患者,我们的方法不是进行端到端预测,而是首先在学习的度量空间中搜索具有已知 OS 时间的最近患者,然后由最近患者共同确定输入患者的最终 OS 时间,这对数据不一致性和噪声具有鲁棒性。此外,为了利用多种成像模态,引入了新的模态间损失,以鼓励从不同模态学习互补特征。使用包含 78 名 GBM 患者的多模态磁共振脑图像的内部单中心数据集来评估我们的方法。此外,为了证明我们的方法不仅限于 GBM,还在我们的实验中使用了包含低级别和高级别胶质瘤的公共多中心数据集(BRATS2019)。由于受益于深度 KNN 和模态间损失,我们的方法在两个数据集的所有评估方法中表现都更好。据我们所知,这是第一个在 DL 框架下以 KNN 策略预测 GBM 患者 OS 时间的工作。