用眼底影像和临床数据,提升中风预测准确率。
Multimodal Deep Learning for Stroke Prediction and Detection using Retinal Imaging and Clinical Data
- 融合OCT、红外成像与临床数据的多模态深度学习模型。
- 相比单图像模型提升5% AUROC,优于现有顶尖模型8%。
- 适合医疗筛查、早期预警系统开发者参考。
中风是全球重大公共卫生问题。深度学习在中风诊断与风险预测中展现潜力,但现有方法依赖昂贵的医学影像(如计算机断层扫描)。近期研究发现,眼底成像可作为脑血管健康评估的低成本替代方案,因视网膜与大脑共享临床通路。本研究探索结合眼底图像与临床数据进行中风检测与风险预测的效果。提出一种多模态深度神经网络,处理光学相干断层扫描(OCT)和红外反射眼底图像,并融合人口统计学、生命体征及诊断编码等临床数据。模型基于包含3.7万张扫描的真实世界数据集进行自监督预训练,随后在小规模标注子集上微调与评估。实证结果表明,所考虑模态能有效识别急性中风后视网膜长期改变,并在特定时间窗内预测未来风险。实验显示,该框架相比仅使用图像的单模态基线模型提升5% AUROC,较现有最先进基础模型提升8%。结论表明,眼底成像有望用于高危人群识别,改善长期预后。
原文摘要 · Abstract (English)
Stroke is a major public health problem, affecting millions worldwide. Deep learning has recently demonstrated promise for enhancing the diagnosis and risk prediction of stroke. However, existing methods rely on costly medical imaging modalities, such as computed tomography. Recent studies suggest that retinal imaging could offer a cost-effective alternative for cerebrovascular health assessment due to the shared clinical pathways between the retina and the brain. Hence, this study explores the impact of leveraging retinal images and clinical data for stroke detection and risk prediction. We propose a multimodal deep neural network that processes Optical Coherence Tomography (OCT) and infrared reflectance retinal scans, combined with clinical data, such as demographics, vital signs, and diagnosis codes. We pretrained our model using a self-supervised learning framework using a real-world dataset consisting of $37$ k scans, and then fine-tuned and evaluated the model using a smaller labeled subset. Our empirical findings establish the predictive ability of the considered modalities in detecting lasting effects in the retina associated with acute stroke and forecasting future risk within a specific time horizon. The experimental results demonstrate the effectiveness of our proposed framework by achieving $5$\% AUROC improvement as compared to the unimodal image-only baseline, and $8$\% improvement compared to an existing state-of-the-art foundation model. In conclusion, our study highlights the potential of retinal imaging in identifying high-risk patients and improving long-term outcomes.
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