融合影像特征与临床指标,提升心脏病风险预测准确率。
A Joint Representation Using Continuous and Discrete Features for Cardiovascular Diseases Risk Prediction on Chest CT Scans
- 联合连续深度特征与离散量化指标构建新表征
- 在两个数据集上达0.875和0.843的AUC表现
- 提供可解释性分析,辅助医生决策
心血管疾病(CVD)仍是全球主要健康威胁,尽管临床进展降低了死亡率,但精准识别可从预防干预中获益者仍是预防心脏病学中的未解难题。现有风险预测模型多依赖有限的传统风险因素或仅通过CT获取定量生物标志物,仍存在预测精度与适用性不足的问题。而基于深度学习的端到端方法虽性能优越,却缺乏透明可解释的决策依据。本文提出一种新型联合表征方法,整合胸部CT扫描中提取的连续深度特征与临床已确立的离散量化生物标志物。首先通过深度学习模型捕获全面的连续特征,并利用分割模型同步获得临床指标;随后采用实例级特征门控机制对齐两类特征,再通过软实例级特征交互机制实现独立有效的特征融合,最终完成CVD风险预测。该方法显著提升预测性能,并支持各生物标志物的个体贡献度分析,有助于医生决策。我们在公开低剂量胸部CT数据集及私有标准剂量患者队列(共17,207例影像,6,393名受试者)上验证,分别取得0.875和0.843的AUC表现,优于现有方法。
原文摘要 · Abstract (English)
Cardiovascular diseases (CVD) remain a leading health concern and contribute significantly to global mortality rates. While clinical advancements have led to a decline in CVD mortality, accurately identifying individuals who could benefit from preventive interventions remains an unsolved challenge in preventive cardiology. Current CVD risk prediction models, recommended by guidelines, are based on limited traditional risk factors or use CT imaging to acquire quantitative biomarkers, and still have limitations in predictive accuracy and applicability. On the other hand, end-to-end trained CVD risk prediction methods leveraging deep learning on CT images often fail to provide transparent and explainable decision grounds for assisting physicians. In this work, we proposed a novel joint representation that integrates discrete quantitative biomarkers and continuous deep features extracted from chest CT scans. Our approach initiated with a deep CVD risk classification model by capturing comprehensive continuous deep learning features while jointly obtaining currently clinical-established quantitative biomarkers via segmentation models. In the feature joint representation stage, we use an instance-wise feature-gated mechanism to align the continuous and discrete features, followed by a soft instance-wise feature interaction mechanism fostering independent and effective feature interaction for the final CVD risk prediction. Our method substantially improves CVD risk predictive performance and offers individual contribution analysis of each biomarker, which is important in assisting physicians' decision-making processes. We validated our method on a public chest low-dose CT dataset and a private external chest standard-dose CT patient cohort of 17,207 CT volumes from 6,393 unique subjects, and demonstrated superior predictive performance, achieving AUCs of 0.875 and 0.843, respectively.
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