A Self-supervised Multimodal Deep Learning Approach to Differentiate Post-radiotherapy Progression from Pseudoprogression in Glioblastoma

Fuente: arXiv
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Autori principali: Gomaa, Ahmed, Huang, Yixing, Stephan, Pluvio, Breininger, Katharina, Frey, Benjamin, Dörfler, Arnd, Schnell, Oliver, Delev, Daniel, Coras, Roland, Schmitter, Charlotte, Stritzelberger, Jenny, Semrau, Sabine, Maier, Andreas, Bayer, Siming, Schönecker, Stephan, Heiland, Dieter H, Hau, Peter, Gaipl, Udo S., Bert, Christoph, Fietkau, Rainer, Schmidt, Manuel A., Putz, Florian
Natura: Preprint
Pubblicazione: 2025
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author Gomaa, Ahmed
Huang, Yixing
Stephan, Pluvio
Breininger, Katharina
Frey, Benjamin
Dörfler, Arnd
Schnell, Oliver
Delev, Daniel
Coras, Roland
Schmitter, Charlotte
Stritzelberger, Jenny
Semrau, Sabine
Maier, Andreas
Bayer, Siming
Schönecker, Stephan
Heiland, Dieter H
Hau, Peter
Gaipl, Udo S.
Bert, Christoph
Fietkau, Rainer
Schmidt, Manuel A.
Putz, Florian
author_facet Gomaa, Ahmed
Huang, Yixing
Stephan, Pluvio
Breininger, Katharina
Frey, Benjamin
Dörfler, Arnd
Schnell, Oliver
Delev, Daniel
Coras, Roland
Schmitter, Charlotte
Stritzelberger, Jenny
Semrau, Sabine
Maier, Andreas
Bayer, Siming
Schönecker, Stephan
Heiland, Dieter H
Hau, Peter
Gaipl, Udo S.
Bert, Christoph
Fietkau, Rainer
Schmidt, Manuel A.
Putz, Florian
contents Accurate differentiation of pseudoprogression (PsP) from True Progression (TP) following radiotherapy (RT) in glioblastoma (GBM) patients is crucial for optimal treatment planning. However, this task remains challenging due to the overlapping imaging characteristics of PsP and TP. This study therefore proposes a multimodal deep-learning approach utilizing complementary information from routine anatomical MR images, clinical parameters, and RT treatment planning information for improved predictive accuracy. The approach utilizes a self-supervised Vision Transformer (ViT) to encode multi-sequence MR brain volumes to effectively capture both global and local context from the high dimensional input. The encoder is trained in a self-supervised upstream task on unlabeled glioma MRI datasets from the open BraTS2021, UPenn-GBM, and UCSF-PDGM datasets to generate compact, clinically relevant representations from FLAIR and T1 post-contrast sequences. These encoded MR inputs are then integrated with clinical data and RT treatment planning information through guided cross-modal attention, improving progression classification accuracy. This work was developed using two datasets from different centers: the Burdenko Glioblastoma Progression Dataset (n = 59) for training and validation, and the GlioCMV progression dataset from the University Hospital Erlangen (UKER) (n = 20) for testing. The proposed method achieved an AUC of 75.3%, outperforming the current state-of-the-art data-driven approaches. Importantly, the proposed approach relies on readily available anatomical MRI sequences, clinical data, and RT treatment planning information, enhancing its clinical feasibility. The proposed approach addresses the challenge of limited data availability for PsP and TP differentiation and could allow for improved clinical decision-making and optimized treatment plans for GBM patients.
format Preprint
id arxiv_https___arxiv_org_abs_2502_03999
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle A Self-supervised Multimodal Deep Learning Approach to Differentiate Post-radiotherapy Progression from Pseudoprogression in Glioblastoma
Gomaa, Ahmed
Huang, Yixing
Stephan, Pluvio
Breininger, Katharina
Frey, Benjamin
Dörfler, Arnd
Schnell, Oliver
Delev, Daniel
Coras, Roland
Schmitter, Charlotte
Stritzelberger, Jenny
Semrau, Sabine
Maier, Andreas
Bayer, Siming
Schönecker, Stephan
Heiland, Dieter H
Hau, Peter
Gaipl, Udo S.
Bert, Christoph
Fietkau, Rainer
Schmidt, Manuel A.
Putz, Florian
Image and Video Processing
Computer Vision and Pattern Recognition
Accurate differentiation of pseudoprogression (PsP) from True Progression (TP) following radiotherapy (RT) in glioblastoma (GBM) patients is crucial for optimal treatment planning. However, this task remains challenging due to the overlapping imaging characteristics of PsP and TP. This study therefore proposes a multimodal deep-learning approach utilizing complementary information from routine anatomical MR images, clinical parameters, and RT treatment planning information for improved predictive accuracy. The approach utilizes a self-supervised Vision Transformer (ViT) to encode multi-sequence MR brain volumes to effectively capture both global and local context from the high dimensional input. The encoder is trained in a self-supervised upstream task on unlabeled glioma MRI datasets from the open BraTS2021, UPenn-GBM, and UCSF-PDGM datasets to generate compact, clinically relevant representations from FLAIR and T1 post-contrast sequences. These encoded MR inputs are then integrated with clinical data and RT treatment planning information through guided cross-modal attention, improving progression classification accuracy. This work was developed using two datasets from different centers: the Burdenko Glioblastoma Progression Dataset (n = 59) for training and validation, and the GlioCMV progression dataset from the University Hospital Erlangen (UKER) (n = 20) for testing. The proposed method achieved an AUC of 75.3%, outperforming the current state-of-the-art data-driven approaches. Importantly, the proposed approach relies on readily available anatomical MRI sequences, clinical data, and RT treatment planning information, enhancing its clinical feasibility. The proposed approach addresses the challenge of limited data availability for PsP and TP differentiation and could allow for improved clinical decision-making and optimized treatment plans for GBM patients.
title A Self-supervised Multimodal Deep Learning Approach to Differentiate Post-radiotherapy Progression from Pseudoprogression in Glioblastoma
topic Image and Video Processing
Computer Vision and Pattern Recognition
url https://arxiv.org/abs/2502.03999