Abstract:Image-based characterization and disease understanding involve integrative analysis of morphological, spatial, and topological information across biological scales. The development of graph convolutional networks (GCNs) has created the opportunity to address this information complexity via graph-driven architectures, since GCNs can perform feature aggregation, interaction, and reasoning with remarkable flexibility and efficiency. These GCNs capabilities have spawned a new wave of research in medical imaging analysis with the overarching goal of improving quantitative disease understanding, monitoring, and diagnosis. Yet daunting challenges remain for designing the important image-to-graph transformation for multi-modality medical imaging and gaining insights into model interpretation and enhanced clinical decision support. In this review, we present recent GCNs developments in the context of medical image analysis including imaging data from radiology and histopathology. We discuss the fast-growing use of graph network architectures in medical image analysis to improve disease diagnosis and patient outcomes in clinical practice. To foster cross-disciplinary research, we present GCNs technical advancements, emerging medical applications, identify common challenges in the use of image-based GCNs and their extensions in model interpretation, large-scale benchmarks that promise to transform the scope of medical image studies and related graph-driven medical research.