arXiv:2503.23042eess.IVcs.CV2025-03被引 1

比较了用全切片图像预测肾癌患者生存期的两种策略,发现选最代表性的切片效果更好。

MIL vs. Aggregation: Evaluating Patient-Level Survival Prediction Strategies Using Graph-Based Learning

  • 采用MIL方法自动挑选最具代表性的切片,而非全部使用
  • 在MMIST-ccRCC数据集上,该策略提升生存预测准确率
  • 适合关注医学影像分析与个性化诊疗的研究者

肿瘤学家常依赖全切片图像(WSIs)等多源数据制定治疗方案,以实现最佳患者预后。然而,由于肿瘤异质性和患者内部变异,以及WSI本身规模巨大(含数十亿像素),直接处理极为耗时,需特殊方法提取有效信息。同一患者可能有多个不同区域的WSI,其中部分更具诊断价值。这引出核心问题:应使用所有切片,还是仅选取最具代表性的一张?本文通过对比多种基于图神经网络的生存预测策略,在包含透明细胞肾细胞癌(ccRCC)患者的MMIST-ccRCC数据集上展开研究。策略包括将每个WSI视为独立样本,或通过聚合多个预测结果、或使用多实例学习(MIL)自动筛选最相关切片。实验表明,基于MIL的选择方法显著提升预测精度,证明选取最具代表性的切片更有利于生存预判。

原文摘要 · Abstract (English)

Oncologists often rely on a multitude of data, including whole-slide images (WSIs), to guide therapeutic decisions, aiming for the best patient outcome. However, predicting the prognosis of cancer patients can be a challenging task due to tumor heterogeneity and intra-patient variability, and the complexity of analyzing WSIs. These images are extremely large, containing billions of pixels, making direct processing computationally expensive and requiring specialized methods to extract relevant information. Additionally, multiple WSIs from the same patient may capture different tumor regions, some being more informative than others. This raises a fundamental question: Should we use all WSIs to characterize the patient, or should we identify the most representative slide for prognosis? Our work seeks to answer this question by performing a comparison of various strategies for predicting survival at the WSI and patient level. The former treats each WSI as an independent sample, mimicking the strategy adopted in other works, while the latter comprises methods to either aggregate the predictions of the several WSIs or automatically identify the most relevant slide using multiple-instance learning (MIL). Additionally, we evaluate different Graph Neural Networks architectures under these strategies. We conduct our experiments using the MMIST-ccRCC dataset, which comprises patients with clear cell renal cell carcinoma (ccRCC). Our results show that MIL-based selection improves accuracy, suggesting that choosing the most representative slide benefits survival prediction.

生存预测医学影像图神经网络MIL

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