用可解释深度学习发现肿瘤影像标志物,兼顾准确与临床可信度。
An Interpretable Deep Learning Framework for Discovery and Clinical Validation of Deep Radiomic Signatures in Tumor Classification
- 分步整合分割、可解释分类与放射组学分析,实现可复现的影像标志物提取
- 在乳腺、肾癌和脑瘤数据集上,分类性能优于传统全肿瘤分析方法
- 通过SHAP等方法揭示关键生物标志物,适合医学影像研究与临床转化
影像标志物是从医学图像中提取的定量特征,为肿瘤诊断、表征、预后及治疗规划提供临床意义信息。尽管深度学习在影像标志物发现方面展现出巨大潜力,但其可解释性不足仍是临床应用的主要障碍。现有方法虽具备高预测性能,却难以提供生物学洞见。本文提出一个统一的可解释影像标志物发现框架,集成基于深度学习的分割、可解释分类与放射组学分析。首先使用鲁棒分割模型精确勾画肿瘤区域,随后通过Grad-CAM引导的流程识别具有诊断意义的区域作为候选影像标志物。采用基于互信息的自适应阈值策略实现患者特异性标志物提取。所得标志物经下游深度学习分类模型验证,同时从标志物区域提取的放射组学特征由传统机器学习模型评估,并利用SHAP进行解释,以识别最具区分性的生物标志物。该框架在公开的BUSI乳腺超声、KiTS肾部CT、BraTS脑肿瘤数据集以及私有的UF Health肾部CT队列上进行评估。相比传统全肿瘤放射组学,本方法在提升判别性能的同时显著增强生物学可解释性。通过将深度学习注意力转化为可重复的定量影像生物标志物,该框架为非侵入性肿瘤表征与影像生物标志物发现提供了可解释且可复现的解决方案。
原文摘要 · Abstract (English)
Imaging signatures are quantitative features extracted from medical images that provide clinically meaningful information for tumor diagnosis, characterization, prognosis, and treatment planning. Although deep learning has shown great potential for imaging signature discovery, its limited interpretability remains a major barrier to clinical adoption. Existing approaches often achieve high predictive performance but provide little biological insight into the identified signatures. We propose a unified framework for interpretable imaging signature discovery by integrating deep learning based segmentation, explainable classification, and radiomic analysis. A robust segmentation model is first used to accurately delineate tumors, followed by a Grad-CAM guided pipeline that identifies diagnostically important regions as candidate imaging signatures. A mutual information based adaptive thresholding strategy enables patient-specific signature extraction. The resulting signatures are validated using a downstream deep learning classification model, while radiomic features extracted from the signature regions are evaluated with traditional machine learning models and interpreted using SHAP to identify the most discriminative biomarkers. The proposed framework is evaluated on the public BUSI breast ultrasound, KiTS renal CT, and BraTS brain tumor datasets, as well as a private UF Health renal CT cohort. Compared with conventional whole-tumor radiomics, the proposed signature-based approach achieves improved discriminative performance while providing greater biological interpretability. By converting deep learning attention into reproducible quantitative imaging biomarkers, this framework offers an interpretable and reproducible solution for non-invasive tumor characterization and imaging biomarker discovery.
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