A prior knowledge-supervised fusion network predicts survival after radiotherapy in patients with advanced gastric cancer.

Abstract

Predicting overall survival (OS) for advanced gastric cancer patients after radiotherapy is critical for developing an individualized treatment plan. However, existing studies have focused on gastric cancer CT images with a large amount of redundant information, neglecting the role of physicians' prior knowledge in guiding gastric cancer CT image information. We propose a multimodal fusion method based on prior knowledge to predict OS after radiotherapy in advanced gastric cancer patients to assist physicians in clinical diagnosis and treatment. A prior knowledge supervised fusion network (PKSFnet) is proposed. Firstly, PKSFnet uses a novel sampling strategy, which enables the input model data to obtain a complete feature space by analyzing the entire patient data space. Afterwards, under the guidance of the multi-domain feature fusion module (MdFF), multimodal information of patients is adaptively fused and mined to improve the prediction performance. The results of the proposed model are superior to those of other unimodal and multimodal state-of-the-art methods. For the segmented survival time classification task, the AUC, specificity, sensitivity, precision of the proposed model are 0.8397, 0.875, 0.7556, and 0.875, respectively. For the survival risk regression task, the C-index and HR of the proposed model are 0.8574 and 4.658 respectively. Ablation experimental results further demonstrate the impact of each module of the proposed model. Finally, we apply the novel sampling strategy to other deep learning models and achieve significant improvement. The experimental results have demonstrated that the proposed model can effectively predict OS after radiotherapy in patients with advanced gastric cancer, which demonstrate that the proposed model can facilitate the development and application of robust clinical treatment strategies.