arXiv:2603.01948cs.CV2026-03

用脑部影像和患者特征预测帕金森手术后效果,准确率达88.89%。

PreSight: Preoperative Outcome Prediction for Parkinson's Disease via Region-Prior Morphometry and Patient-Specific Weighting

  • 融合临床先验与形变形态学分析,动态调整不同脑区重要性。
  • 在400名患者上实现88.89%分类准确率,外部测试达85.29%。
  • 可生成个体化解释,适合临床术前决策支持场景。

帕金森病手术前改善率预测对临床至关重要但极具挑战,因影像信号微弱且患者异质性强。本文提出PreSight模型,仅使用术前信息预测个体化术后运动改善。该模型融合临床先验知识、术前MRI及基于形变的形态学分析(DBM),并通过患者特异性加权模块自适应调整区域重要性。模型输出端到端、校准良好、可直接用于决策的预测结果,并提供患者级解释。在包含400名受试者的双中心真实世界队列中评估,预设条件为多模态术前输入与术后改善标签。PreSight优于多项临床、影像及多模态基线方法,在内部验证中达到88.89%准确率,外部中心测试为85.29%;同时具备更优的概率校准性和更高的决策曲线净收益。消融实验确认了DBM与患者特异性加权模块的贡献,表明模型能以患者为中心聚焦疾病相关脑区。结果证明,将临床先验与区域自适应形态学结合,可实现临床常规实践中的可靠术前决策支持。

原文摘要 · Abstract (English)

Preoperative improvement rate prediction for Parkinson's disease surgery is clinically important yet difficult because imaging signals are subtle and patients are heterogeneous. We address this setting, where only information available before surgery is used, and the goal is to predict patient-specific postoperative motor benefit. We present PreSight, a presurgical outcome model that fuses clinical priors with preoperative MRI and deformation-based morphometry (DBM) and adapts regional importance through a patient-specific weighting module. The model produces end-to-end, calibrated, decision-ready predictions with patient-level explanations. We evaluate PreSight on a real-world two-center cohort of 400 subjects with multimodal presurgical inputs and postoperative improvement labels. PreSight outperforms strong clinical, imaging-only, and multimodal baselines. It attains 88.89% accuracy on internal validation and 85.29% on an external-center test for responder classification and shows better probability calibration and higher decision-curve net benefit. Ablations and analyses confirm the contribution of DBM and the patient-specific weighting module and indicate that the model emphasizes disease-relevant regions in a patient-specific manner. These results demonstrate that integrating clinical prior knowledge with region-adaptive morphometry enables reliable presurgical decision support in routine practice.

帕金森影像预测模型解释术前评估

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