Cited by 400AI in cancer detectionRadiomics and Machine Learning in Medical ImagingMultimodal Machine Learning Applications

Multimodal Co-Attention Transformer for Survival Prediction in Gigapixel Whole Slide Images

Chen, Richard J., Lu, Ming Y., Weng, Wei-Hung, Chen, Tiffany Y., Williamson, Drew FK., Manz, Trevor, Shady, Maha, Mahmood, Faisal·2021·2021 IEEE/CVF International Conference on Computer Vision (ICCV)

Abstract

Survival outcome prediction is a challenging weakly-supervised and ordinal regression task in computational pathology that involves modeling complex interactions within the tumor microenvironment in gigapixel whole slide images (WSIs). Despite recent progress in formulating WSIs as bags for multiple instance learning (MIL), representation learning of entire WSIs remains an open and challenging problem, especially in overcoming: 1) the computational complexity of feature aggregation in large bags, and 2) the data heterogeneity gap in incorporating biological priors such as genomic measurements. In this work, we present a Multimodal Co-Attention Transformer (MCAT) framework that learns an interpretable, dense co-attention mapping between WSIs and genomic features formulated in an embedding space. Inspired by approaches in Visual Question Answering (VQA) that can attribute how word embed-dings attend to salient objects in an image when answering a question, MCAT learns how histology patches attend to genes when predicting patient survival. In addition to visualizing multimodal interactions, our co-attention trans-formation also reduces the space complexity of WSI bags, which enables the adaptation of Transformer layers as a general encoder backbone in MIL. We apply our proposed method on five different cancer datasets (4,730 WSIs, 67 million patches). Our experimental results demonstrate that the proposed method consistently achieves superior performance compared to the state-of-the-art methods.

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Registry

Crossref · 10.1109/iccv48922.2021.00398

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  • In the comparison between the FSM and MCAT [6] models across the TCGA and CPTAC cohorts, the FSM model consistently demonstrated superior performance in predicting survival outcomes for both LUAD and LUSC cases.

    “In the comparison between the FSM and MCAT [6] models across the TCGA and CPTAC cohorts, the FSM model consistently demonstrated superior performance in predicting survival outcomes for both LUAD and LUSC cases.”
  • TAH is applicable to models employing attention-weighted pooling of instances, while CoAttn suits multimodal models that fuse WSI and genomic features using co-attention.

    “TAH is applicable to models employing attention-weighted pooling of instances, while CoAttn suits multimodal models that fuse WSI and genomic features using co-attention.”
  • The work is unique in mixing node and edge embeddings along with fusion of bulk gene expression embeddings to learn a multimodal topographic mapping to predict survival.

    “While other researchers have previously explored the development of mid-level-fusion and mixer architectures [6], [7] as well as the use of graph-based representations of WSIs [8], our work is unique in mixing node and edge embeddings along with fusion of bulk gene expression embeddings to learn a multimodal topographic mapping to predict survival.”

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Authors
Chen, R. J., Lu, M. Y., Weng, W.-H., Chen, T. Y., Williamson, D. F., Manz, T., Shady, M., & Mahmood, F.
Affiliations
  • Broad Institute (US)
  • MIT Computer Science and Artificial Intelligence Laboratory (US)
  • Brigham and Women's Hospital (US)
Venue
2021 IEEE/CVF International Conference on Computer Vision (ICCV)
Publisher
IEEE
Published
2021-10
Pages
3995-4005
OpenAlex
W3203898052
Cited by
398
References
75
Citations by year
2026: 106 · 2025: 121 · 2024: 94 · 2023: 55 · 2022: 22
FWCI
19.71
Type
conference paper
Language
en
Open access
closed
Locations
IEEE/CVF International Conference on Computer Vision (ICCV) (publishedVersion)
Topics
  • Physical Sciences › Computer Science › Artificial Intelligence › AI in cancer detection
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiomics and Machine Learning in Medical Imaging
  • Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Multimodal Machine Learning Applications
Keywords
survival prediction, whole slide images, multimodal representation learning, multiple instance learning, genomic features, tumor microenvironment, visual question answering, ordinal regression, cancer

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