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Main Authors: Malafaia, Mafalda, Bosman, Peter A. N., Rasch, Coen, Alderliesten, Tanja
Format: Preprint
Published: 2025
Subjects:
Online Access:https://arxiv.org/abs/2509.21600
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author Malafaia, Mafalda
Bosman, Peter A. N.
Rasch, Coen
Alderliesten, Tanja
author_facet Malafaia, Mafalda
Bosman, Peter A. N.
Rasch, Coen
Alderliesten, Tanja
contents Accurate and interpretable survival analysis remains a core challenge in oncology. With growing multimodal data and the clinical need for transparent models to support validation and trust, this challenge increases in complexity. We propose an interpretable multimodal AI framework to automate survival analysis by integrating clinical variables and computed tomography imaging. Our MultiFIX-based framework uses deep learning to infer survival-relevant features that are further explained: imaging features are interpreted via Grad-CAM, while clinical variables are modeled as symbolic expressions through genetic programming. Risk estimation employs a transparent Cox regression, enabling stratification into groups with distinct survival outcomes. Using the open-source RADCURE dataset for head and neck cancer, MultiFIX achieves a C-index of 0.838 (prediction) and 0.826 (stratification), outperforming the clinical and academic baseline approaches and aligning with known prognostic markers. These results highlight the promise of interpretable multimodal AI for precision oncology with MultiFIX.
format Preprint
id arxiv_https___arxiv_org_abs_2509_21600
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Automated and Interpretable Survival Analysis from Multimodal Data
Malafaia, Mafalda
Bosman, Peter A. N.
Rasch, Coen
Alderliesten, Tanja
Artificial Intelligence
Machine Learning
Accurate and interpretable survival analysis remains a core challenge in oncology. With growing multimodal data and the clinical need for transparent models to support validation and trust, this challenge increases in complexity. We propose an interpretable multimodal AI framework to automate survival analysis by integrating clinical variables and computed tomography imaging. Our MultiFIX-based framework uses deep learning to infer survival-relevant features that are further explained: imaging features are interpreted via Grad-CAM, while clinical variables are modeled as symbolic expressions through genetic programming. Risk estimation employs a transparent Cox regression, enabling stratification into groups with distinct survival outcomes. Using the open-source RADCURE dataset for head and neck cancer, MultiFIX achieves a C-index of 0.838 (prediction) and 0.826 (stratification), outperforming the clinical and academic baseline approaches and aligning with known prognostic markers. These results highlight the promise of interpretable multimodal AI for precision oncology with MultiFIX.
title Automated and Interpretable Survival Analysis from Multimodal Data
topic Artificial Intelligence
Machine Learning
url https://arxiv.org/abs/2509.21600