Interpretable multi-modal artificial intelligence model for predicting gastric cancer response to neoadjuvant chemotherapy.

Journal: Cell reports. Medicine
PMID: 39637859

Abstract

Neoadjuvant chemotherapy assessment is imperative for prognostication and clinical management of locally advanced gastric cancer. We propose an incremental supervised contrastive learning model (iSCLM), an interpretable artificial intelligence framework integrating pretreatment CT scans and H&E-stained biopsy images, for improved decision-making regarding neoadjuvant chemotherapy. We have constructed and tested iSCLM using retrospective data from 2,387 patients across 10 medical centers and evaluated its discriminative ability in a prospective cohort (132 patients; ChiCTR2300068917). iSCLM achieves areas under receiver operating characteristic curves of 0.846-0.876 across different test cohorts. Computed tomography (CT) and pathological attention heatmaps from Shapley additive explanations and global sort pooling illustrate additional benefits for capturing morphological features through supervised contrastive learning. Specifically, pathological top-ranked tiles exhibit decreased distances to tumor-invasive borders and increased inflammatory cell infiltration in responders compared with non-responders. Moreover, CD11c expression is elevated in responders. The developed interpretable model at the molecular pathology level accurately predicts chemotherapy efficacy.

Authors

  • Peng Gao
    Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, PA, United States.
  • Qiong Xiao
    Department of Surgical Oncology and General Surgery, The First Hospital of China Medical University, Key Laboratory of Precision Diagnosis and Treatment of Gastrointestinal Tumors (China Medical University), Ministry of Education, Shenyang 110001, China.
  • Hui Tan
    College of Food Science, Shenyang Agriculture University, Shenyang, Liaoning 110866, China.
  • Jiangdian Song
    Sino-Dutch Biomedical and Information Engineering School, Northeastern University, Liaoning, Shenyang, 110819, China.
  • Yu Fu
    Molecular Diagnosis and Treatment Center for Infectious Diseases Dermatology Hospital Southern Medical University Guangzhou China.
  • Jingao Xu
    Neusoft Research of Intelligent Healthcare Technology, Co. Ltd., Shenyang 110169, China.
  • Junhua Zhao
    Department of Surgical Oncology and General Surgery, The First Hospital of China Medical University, Key Laboratory of Precision Diagnosis and Treatment of Gastrointestinal Tumors (China Medical University), Ministry of Education, Shenyang 110001, China.
  • Yuan Miao
  • Xiaoyan Li
    Shulan International Medical College, Zhejiang Shuren University, Hangzhou, Zhejiang, China.
  • Yi Jing
    Neusoft Research of Intelligent Healthcare Technology, Co. Ltd., Shenyang 110169, China.
  • Yingying Feng
    School of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China.
  • Zitong Wang
    Department of Colorectal Surgery, The Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Harbin, China.
  • Yingjie Zhang
    College of Chemistry & Environmental Science, Hebei University, Baoding 071002, P. R. China.
  • Enbo Yao
    Department of Surgical Oncology and General Surgery, The First Hospital of China Medical University, Key Laboratory of Precision Diagnosis and Treatment of Gastrointestinal Tumors (China Medical University), Ministry of Education, Shenyang 110001, China.
  • Tongjia Xu
    Department of Surgical Oncology and General Surgery, The First Hospital of China Medical University, Key Laboratory of Precision Diagnosis and Treatment of Gastrointestinal Tumors (China Medical University), Ministry of Education, Shenyang 110001, China.
  • Jipeng Mei
    Department of Surgical Oncology and General Surgery, The First Hospital of China Medical University, Key Laboratory of Precision Diagnosis and Treatment of Gastrointestinal Tumors (China Medical University), Ministry of Education, Shenyang 110001, China.
  • Hanyu Chen
    Department of Surgical Oncology and General Surgery, The First Hospital of China Medical University, Key Laboratory of Precision Diagnosis and Treatment of Gastrointestinal Tumors (China Medical University), Ministry of Education, Shenyang 110001, China.
  • Xue Jiang
    Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710071, China.
  • Yuchong Yang
    Department of GI Medical Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin Key Laboratory of Digestive Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300202, China.
  • Zhengyang Wang
  • Xianchun Gao
    State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, National Clinical Research Center for Digestive Diseases, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
  • Minwen Zheng
    Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an 733399, China.
  • Liying Zhang
    School of Information Engineering, Zhengzhou University, Zhengzhou, Henan, PR China.
  • Min Jiang
    Eli Lilly and Company, Indianapolis, IN, United States.
  • Yuying Long
    Department of Pathology, Shenyang Fifth People Hospital, Shenyang 110001, China.
  • Lijie He
    Department of Oncology, People's Hospital of Liaoning Province, People's Hospital of China Medical University, Shenyang 110000, China.
  • Jinghua Sun
    Department of Medical Oncology, The Second Hospital of Dalian Medical University, Dalian 116021, China.
  • Yanhong Deng
    Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangdong Research Institute of Gastroenterology, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510655, Guangdong, China. dengyanh@mail.sysu.edu.cn.
  • Bin Wang
    State Key Laboratory of Soil Erosion and Dryland Farming on the Loess Plateau, Northwest A&F University, Yangling 712100, China; New South Wales Department of Primary Industries, Wagga Wagga Agricultural Institute, Wagga Wagga 2650, Australia. Electronic address: bin.a.wang@dpi.nsw.gov.au.
  • Yan Zhao
    Emergency Center, Hubei Clinical Research Center for Emergency and Resuscitaion, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
  • Yi Ba
    Cancer Medical Center & Department of Medical Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
  • Guan Wang
    School of Information Science and Technology, Beijing Forestry University, Beijing 100083, China.
  • Yong Zhang
    Outpatient Department of Hepatitis, The Sixth Affiliated People's Hospital of Dalian Medical University, Dalian, Liaoning, China.
  • Ting Deng
    Department of Gynecologic Oncology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China.
  • Dinggang Shen
    School of Biomedical Engineering, ShanghaiTech University, Shanghai, China.
  • Zhenning Wang
    Department of Surgical Oncology and General Surgery, The First Hospital of China Medical University, Key Laboratory of Precision Diagnosis and Treatment of Gastrointestinal Tumors (China Medical University), Ministry of Education, Shenyang 110001, China. Electronic address: znwang@cmu.edu.cn.

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