让病理诊断模型像医生一样讲清楚判断依据。
ConceptM$^3$oE: Concept-Guided Multimodal Mixture of Experts for Interpretable Computational Pathology

- 用多专家架构分离不同模态的诊断信息,构建可解释的概念通道。
- 在小样本下宏平均F1提升至66.70%,比基线高10个百分点。
- 适合需要透明决策过程的临床医疗AI研发者使用。
医疗模型正从单一模态预测转向多源异构诊断信息的融合推理。在复杂肿瘤亚型中,仅靠形态学难以区分时,病理报告与分子数据可补充全切片图像信息,但现有模型常无法阐明各信号如何整合为可识别的诊断概念。本文提出ConceptM³oE(概念引导的多模态专家混合),将概念形成嵌入交互感知的专家混合路径中。该架构将证据分解为模态特异性、冗余和协同专家,投影至结构化概念瓶颈,映射潜在特征到形态与生物标志物概念层级。为避免可解释瓶颈导致的信息损失,每个专家内设残差路径,使任务相关信号既可通过概念传导,也可直接抵达最终预测,兼顾性能与可解释性。在机构儿科脑肿瘤队列与公开胶质瘤队列上,模型性能媲美无约束模型,并生成经独立神经病理学家验证的推理轨迹。数据受限时,概念引导模型在小规模训练下宏平均F1从56.41%提升至66.70%,且训练收敛更快,体现概念学习的正则化效应。本工作为高性能、可验证的医疗AI提供了可扩展路径,更契合临床复杂决策需求。
原文摘要 · Abstract (English)
Healthcare models are transitioning from unimodal prediction toward multimodal reasoning over heterogeneous diagnostic inputs. In computational pathology, for complex tumor subtypes where morphology alone can be challenging to distinguish, pathology reports and molecular measurements may provide additional diagnostic evidence alongside whole-slide images, yet existing models often fail to clarify how diverse signals assemble into recognizable diagnostic concepts. We propose ConceptM$^3$oE (Concept Multimodal MoE), which embeds concept formation directly within interaction-aware mixture-of-experts (MoE) pathways. The architecture decomposes evidence into modality-specific, redundant, and synergistic experts, which are then projected into structured concept bottlenecks mapping latent features to a hierarchy of morphology and biomarker concepts. To prevent the information loss typical of interpretable bottlenecks, we utilize residual pathways within each expert to allow task-relevant signals to flow both through the concepts and directly to the final task prediction, so that high performance is maintained alongside interpretability. Across an institutional pediatric brain tumor cohort and a public glioma cohort, the framework delivers competitive performance to unconstrained models while producing reasoning traces validated by an independent neuropathologist. In data-limited regimes, ConceptM$^3$oE improves limited-data performance, increasing macro-F1 from 56.41% to 66.70% at small training sizes compared to non-concept-informed baselines, while also showing faster training convergence consistent with the regularizing effect of concept learning. This work offers a scalable path toward high-performance medical AI that is inherently verifiable and better aligned with the complex decision-making of clinical practice.
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