用视觉变压器+自编码器+可解释性分析,提升癌症患者风险分层准确率
Vision Transformers with Autoencoders and Explainable AI for Cancer Patient Risk Stratification Using Whole Slide Imaging
- 融合ViT与自编码器提取病理图像特征
- 在乳腺癌和胶质瘤中实现有效风险分组,生存分析验证显著差异
- 通过SHAP定位关键区域,可视化结果增强临床可信度
癌症仍是全球主要死亡原因之一,亟需精准诊断与预后。随着数字病理学发展,全幻灯片成像(WSI)已融入临床流程。尽管已有研究使用WSI,但其提取特征可能未能充分捕捉关键病理信息,且缺乏可解释性限制了临床应用。本文提出PATH-X框架,结合视觉变换器(ViT)与自编码器,并引入SHAP(Shapley Additive Explanations)以提升可解释性,用于从TCGA获取的WSI进行患者分层与风险预测。每张WSI选取代表性图像切片,使用Google预训练的ViT提取数值特征嵌入,再经自编码器压缩,用于无监督聚类与分类任务。采用Kaplan-Meier生存分析评估分为两组或三组的风险分层效果。通过SHAP识别关键贡献特征,并映射至组织病理切片以提供空间上下文。PATH-X在乳腺癌和胶质瘤中表现良好,因样本量充足可实现稳健分层;而肺癌表现受限于数据量,凸显更大数据集对模型可靠性与临床适用性的必要性。
原文摘要 · Abstract (English)
Cancer remains one of the leading causes of mortality worldwide, necessitating accurate diagnosis and prognosis. Whole Slide Imaging (WSI) has become an integral part of clinical workflows with advancements in digital pathology. While various studies have utilized WSIs, their extracted features may not fully capture the most relevant pathological information, and their lack of interpretability limits clinical adoption. In this paper, we propose PATH-X, a framework that integrates Vision Transformers (ViT) and Autoencoders with SHAP (Shapley Additive Explanations) to enhance model explainability for patient stratification and risk prediction using WSIs from The Cancer Genome Atlas (TCGA). A representative image slice is selected from each WSI, and numerical feature embeddings are extracted using Google's pre-trained ViT. These features are then compressed via an autoencoder and used for unsupervised clustering and classification tasks. Kaplan-Meier survival analysis is applied to evaluate stratification into two and three risk groups. SHAP is used to identify key contributing features, which are mapped onto histopathological slices to provide spatial context. PATH-X demonstrates strong performance in breast and glioma cancers, where a sufficient number of WSIs enabled robust stratification. However, performance in lung cancer was limited due to data availability, emphasizing the need for larger datasets to enhance model reliability and clinical applicability.
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