Abstract
Predicting meningioma grade before surgery is crucial to making decisions on therapy planning and prognosis prediction. Prior works mainly investigate traditional classification techniques with hand-crafted features or rely on image data only, thus having limited accuracy. In this study, we propose a novel multi-modal classification method, i.e., multi-modal deep-fusion network (MMDF), integrating high-dimensional 3D MRI imaging information and low-dimensional tabular clinical data to classify low-grade and high-grade meningiomas. Specifically, the MMDF adopts two modality-specific branches to extract image and clinical features, respectively, and leverages an image-clinical integration module in the shared branch to fuse cross-model features, while specifically considering the impact of low-dimensional clinical data. Besides, we propose a multi-modal image feature aggregation module to integrate three image modalities in the image-specific branch, which can compensate for the feature distribution gaps among the contrast-enhanced T1, contrast-enhanced T2-FLAIR and ADC modalities. Comprehensive experiments show that our approach significantly outperforms the SOTA methods using imaging data only and those combining image and tabular data both, with an AUC of 0.958, sensitivity of 0.877, specificity of 0.926, and accuracy of 0.921. Our approach holds high potential to aid radiologists in doing the presurgical evaluation for clinical decision making.






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Data availability
The dataset cannot be released at present because of the hospital’s requirements for data protection.
Notes
We also found that ADC modality achieves the best results among using the three modalities individually.
References
Abiwinanda, N., Hanif, M., Hesaputra, S.T., Handayani, A., Mengko, T.R.: Brain tumor classification using convolutional neural network. In: World congress on medical physics and biomedical engineering 2018, pp. 183–189. Springer (2019)
Banerjee, S., Mitra, S., Masulli, F., Rovetta, S.: Deep radiomics for brain tumor detection and classification from multi-sequence mri. arXiv preprint arXiv:1903.09240 (2019)
Banerjee, S., Mitra, S., Masulli, F., Rovetta, S.: Deep radiomics for brain tumor detection and classification from multi-sequence mri. arXiv preprint arXiv:1903.09240 (2019)
Cornelius, J.F., Slotty, P.J., Steiger, H.J., Hänggi, D., Polivka, M., George, B.: Malignant potential of skull base versus non-skull base meningiomas: clinical series of 1,663 cases. Acta Neurochirurgica 155(3), 407–413 (2013)
Dai, Z., Liu, H., Le, Q.V., Tan, M.: Coatnet: marrying convolution and attention for all data sizes. Adv. Neural Inf. Process. Syst. 34, 3965–3977 (2021)
Deepak, S., Ameer, P.M.: Brain tumor classification using deep CNN features via transfer learning. Comput. Biol. Med. 111, 103345 (2019)
Dosovitskiy, A., Beyer, L., Kolesnikov, A., Weissenborn, D., Zhai, X., Unterthiner, T., Dehghani, M., Minderer, M., Heigold, G., Gelly, S., et al.: An image is worth 16x16 words: transformers for image recognition at scale. arXiv preprint arXiv:2010.11929 (2020)
El-Dahshan, E.S.A., Mohsen, H.M., Revett, K., Salem, A.B.M.: Computer-aided diagnosis of human brain tumor through mri: a survey and a new algorithm. Expert Syst. Appl. 41(11), 5526–5545 (2014)
Guo, Z., Li, X., Huang, H., Guo, N., Li, Q.: Medical image segmentation based on multi-modal convolutional neural network: study on image fusion schemes. In: 2018 IEEE 15th International Symposium on Biomedical Imaging (ISBI 2018), pp. 903–907. IEEE (2018)
Hawkins-Daarud, A., Rockne, R.C., Anderson, A.R., Swanson, K.R.: Modeling tumor-associated edema in gliomas during anti-angiogenic therapy and its impact on imageable tumor. Front. Oncol. 3, 66 (2013)
He, K., Zhang, X., Ren, S., Sun, J.: Deep residual learning for image recognition pp. 770–778 (2016)
Huang, G., Liu, Z., Van Der Maaten, L., Weinberger, K.Q.: Densely connected convolutional networks. In: Proceedings of the IEEE conference on computer vision and pattern recognition, pp. 4700–4708 (2017)
Jie, H., Li, S., Gang, S., Albanie, S.: Squeeze-and-excitation networks. IEEE Trans. Pattern Anal. Mach. Intell. PP(99) (2017)
Kunyi, Z.: Imaging principles and clinical applications of magnetic resonance imaging (mri). J. Med. Equip. (2008)
Park, Y.W., Oh, J., You, S.C., Han, K., Ahn, S.S., Choi, Y.S., Chang, J.H., Kim, S.H., Lee, S.K.: Radiomics and machine learning may accurately predict the grade and histological subtype in meningiomas using conventional and diffusion tensor imaging. Eur. Radiol. 29(8), 4068–4076 (2019)
Perez, E., Strub, F., De Vries, H., Dumoulin, V., Courville, A.: Film: Visual reasoning with a general conditioning layer. In: Proceedings of the AAAI Conference on Artificial Intelligence, vol. 32 (2018)
Pölsterl, S., Wolf, T.N., Wachinger, C.: Combining 3d image and tabular data via the dynamic affine feature map transform. In: International Conference on Medical Image Computing and Computer-Assisted Intervention, pp. 688–698. Springer (2021)
Qu, Y., Zhu, H., Cao, K., Li, X., Sun, Y.: Prediction of pathological complete response to neoadjuvant chemotherapy in breast cancer using a deep learning (dl) method. Thorac. Cancer 11(3), 651 (2020)
Saraf, S., McCarthy, B.J., Villano, J.L.: Update on meningiomas. The Oncologist 16(11), 1604–1613 (2011)
Shaowei, Z., Liujun, H., Shaolei, G., Xioayi, L., Zhunyi, Z., Shaochun, S., Shujia, C.: Analysis of meningioma recurrence rates following treatment. Lingnan Modern Clin. Surg. 17(06), 742 (2017)
Srinivas, A., Lin, T.Y., Parmar, N., Shlens, J., Abbeel, P., Vaswani, A.: Bottleneck transformers for visual recognition. In: Proceedings of the IEEE/CVF conference on computer vision and pattern recognition, pp. 16,519–16,529 (2021)
Surov, A., Gottschling, S., Mawrin, C., Prell, J., Spielmann, R.P., Wienke, A., Fiedler, E.: Diffusion-weighted imaging in meningioma: prediction of tumor grade and association with histopathological parameters. Transl. Oncol. 8(6), 517–523 (2015)
Talo, M., Baloglu, U.B., Yıldırım, Ö., Acharya, U.R.: Application of deep transfer learning for automated brain abnormality classification using mr images. Cogn. Syst. Res. 54, 176–188 (2019)
Tseng, K.L., Lin, Y.L., Hsu, W., Huang, C.Y.: Joint sequence learning and cross-modality convolution for 3d biomedical segmentation. In: Proceedings of the IEEE conference on Computer Vision and Pattern Recognition, pp. 6393–6400 (2017)
Yan, P.F., Yan, L., Hu, T.T., Xiao, D.D., Feng, J.: The potential value of preoperative mri texture and shape analysis in grading meningiomas: a preliminary investigation. Transl. Oncol. 10(4), 570–577 (2017)
Yang, S.Y., Park, C.K., Park, S.H., Kim, D.G., Chung, Y.S., Jung, H.W.: Atypical and anaplastic meningiomas: prognostic implications of clinicopathological features. J. Neurol. Neurosurg. Psychiatry 79(5), 574–580 (2008)
Yin, B., Liu, L., Zhang, B.Y., Li, Y.X., Li, Y., Geng, D.Y.: Correlating apparent diffusion coefficients with histopathologic findings on meningiomas. Eur. J. Radiol. 81(12), 4050–4056 (2012)
Zeng, Z., Tong, Z., Han, Z., Zhang, Y., Zwiggelaar, R.: The classification of meningioma subtypes based on the color segmentation and shape features. In: Frontier and future development of information technology in medicine and education, pp. 2669–2674. Springer (2014)
Zhang, H., Berg, A.C., Maire, M., Malik, J.: Svm-knn: discriminative nearest neighbor classification for visual category recognition. In: 2006 IEEE Computer Society Conference on Computer Vision and Pattern Recognition (CVPR’06), vol. 2, pp. 2126–2136. IEEE (2006)
Zhang, H., Mo, J., Jiang, H., Li, Z., Hu, W., Zhang, C., Wang, Y., Wang, X., Liu, C., Zhao, B., et al.: Deep learning model for the automated detection and histopathological prediction of meningioma. Neuroinformatics 19(3), 393–402 (2021)
Zhou, B., Khosla, A., Lapedriza, A., Oliva, A., Torralba, A.: Learning deep features for discriminative localization. In: Proceedings of the IEEE conference on computer vision and pattern recognition, pp. 2921–2929 (2016)
Zhu, H., Fang, Q., He, H., Hu, J., Xu, K.: Automatic prediction of meningioma grade image based on data amplification and improved convolutional neural network. Comput. Math. Methods Med. 2019(33), 1–9 (2019)
Zhu, Y., Man, C., Gong, L., Dong, D., Tian, J.: A deep learning radiomics model for preoperative grading in meningioma. Eur. J. Radiol. 116, 128–134 (2019)
Zhu, Y., Man, C., Gong, L., Dong, D., Yu, X., Wang, S., Fang, M., Wang, S., Fang, X., Chen, X., et al.: A deep learning radiomics model for preoperative grading in meningioma. Eur. J. Radiol. 116, 128–134 (2019)
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This work was supported by the grant from Tianjin Natural Science Foundation (Grant No. 20JCYBJC00960).
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Liu, W., Liu, T., Han, T. et al. Multi-modal deep-fusion network for meningioma presurgical grading with integrative imaging and clinical data. Vis Comput 39, 3561–3571 (2023). https://doi.org/10.1007/s00371-023-02978-9
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DOI: https://doi.org/10.1007/s00371-023-02978-9

