Beyond unimodal analysis: Multimodal ensemble learning for enhanced assessment of atherosclerotic disease progression.

Journal: Computerized medical imaging and graphics : the official journal of the Computerized Medical Imaging Society
Published Date:

Abstract

Atherosclerosis is a leading cardiovascular disease typified by fatty streaks accumulating within arterial walls, culminating in potential plaque ruptures and subsequent strokes. Existing clinical risk scores, such as systematic coronary risk estimation and Framingham risk score, profile cardiovascular risks based on factors like age, cholesterol, and smoking, among others. However, these scores display limited sensitivity in early disease detection. Parallelly, ultrasound-based risk markers, such as the carotid intima media thickness, while informative, only offer limited predictive power. Notably, current models largely focus on either ultrasound image-derived risk markers or clinical risk factor data without combining both for a comprehensive, multimodal assessment. This study introduces a multimodal ensemble learning framework to assess atherosclerosis severity, especially in its early sub-clinical stage. We utilize a multi-objective optimization targeting both performance and diversity, aiming to integrate features from each modality effectively. Our objective is to measure the efficacy of models using multimodal data in assessing vascular aging, i.e., plaque presence and vascular age, over a six-year period. We also delineate a procedure for optimal model selection from a vast pool, focusing on best-suited models for classification tasks. Additionally, through eXplainable Artificial Intelligence techniques, this work delves into understanding key model contributors and discerning unique subject subgroups.

Authors

  • Valerio Guarrasi
    Unit of Computer Systems and Bioinformatics, Department of Engineering, University Campus Bio-Medico of Rome, Italy; Department of Computer, Control, and Management Engineering, Sapienza University of Rome, Italy. Electronic address: valerio.guarrasi@unicampus.it.
  • Amanda Bertgren
    Department of Diagnostics and Intervention, Biomedical Engineering and Radiation Physics, Umeå University, Umeå, Sweden. Electronic address: amanda.bertgren@regionvasterbotten.se.
  • Ulf Näslund
    Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden. Electronic address: ulf.naslund@umu.se.
  • Patrik Wennberg
    Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. Electronic address: patrik.wennberg@regionvasterbotten.se.
  • Paolo Soda
    Unit of Computer Systems and Bioinformatics, Department of Engineering, University Campus Bio-Medico of Rome, Italy; Department of Radiation Sciences, Radiation Physics, Biomedical Engineering, Umeå, University, Umeå, Sweden. Electronic address: paolo.soda@umu.se.
  • Christer Grönlund
    Department of Diagnostics and Intervention, Biomedical Engineering and Radiation Physics, Umea University, Umea, Sweden. Electronic address: christer.gronlund@umu.se.