用知识图谱和医学先验,从电子病历生成类MRI特征,提升阿尔茨海默病预测能力。
MIRAGE: Knowledge Graph-Guided Cross-Cohort MRI Synthesis for Alzheimer's Disease Prediction
- 基于医学知识图谱与图注意力网络,将病历数据映射到统一语义空间。
- 通过冻结的3D U-Net作为结构约束,使低维表示具备解剖合理性,提升分类准确率13%。
- 无需重建3D影像,适合缺乏MRI但有病历数据的临床研究场景。
阿尔茨海默病(AD)的可靠诊断日益依赖结构磁共振成像(MRI)与电子健康记录(EHR)的多模态融合。然而,由于MRI成本高且在多数患者队列中缺失,模型部署受限。从稀疏的高维表格数据生成全新的3D解剖图像在技术上极具挑战,且存在严重临床风险。为此,我们提出MIRAGE框架,将缺失的MRI问题重构为一种受解剖引导的跨队列潜在空间蒸馏任务。首先,利用生物医学知识图谱(KG)和图注意力网络,将异构的EHR变量映射至统一嵌入空间,并实现从有真实MRI的队列向无MRI队列的语义传播。为弥合语义鸿沟并强制空间物理一致性,采用一个冻结的预训练3D U-Net解码器作为辅助正则化引擎。结合新颖的队列聚合跳连特征补偿策略,该解码器作为严格的结构惩罚项,迫使1D潜在表示编码出具有生物学合理性的宏观病理语义。推理阶段仅使用此蒸馏出的“诊断代理”表示,完全避免了计算昂贵的3D体素重建。实验表明,本框架有效填补了缺失模态的空白,在无真实MRI的队列中,相比单模态基线,AD分类率提升13%。
原文摘要 · Abstract (English)
Reliable Alzheimer's disease (AD) diagnosis increasingly relies on multimodal assessments combining structural Magnetic Resonance Imaging (MRI) and Electronic Health Records (EHR). However, deploying these models is bottlenecked by modality missingness, as MRI scans are expensive and frequently unavailable in many patient cohorts. Furthermore, synthesizing de novo 3D anatomical scans from sparse, high-dimensional tabular records is technically challenging and poses severe clinical risks. To address this, we introduce MIRAGE, a novel framework that reframes the missing-MRI problem as an anatomy-guided cross-modal latent distillation task. First, MIRAGE leverages a Biomedical Knowledge Graph (KG) and Graph Attention Networks to map heterogeneous EHR variables into a unified embedding space that can be propagated from cohorts with real MRIs to cohorts without them. To bridge the semantic gap and enforce physical spatial awareness, we employ a frozen pre-trained 3D U-Net decoder strictly as an auxiliary regularization engine. Supported by a novel cohort-aggregated skip feature compensation strategy, this decoder acts as a rigorous structural penalty, forcing 1D latent representations to encode biologically plausible, macro-level pathological semantics. By exclusively utilizing this distilled "diagnostic-surrogate" representation during inference, MIRAGE completely bypasses computationally expensive 3D voxel reconstruction. Experiments demonstrate that our framework successfully bridges the missing-modality gap, improving the AD classification rate by 13% compared to unimodal baselines in cohorts without real MRIs.
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