Abstract:Predicting stroke risk is a complex challenge that can be enhanced by integrating diverse clinically available data modalities. This study introduces a self-supervised multimodal framework that combines 3D brain imaging, clinical data, and image-derived features to improve stroke risk prediction prior to onset. By leveraging large unannotated clinical datasets, the framework captures complementary and synergistic information across image and tabular data modalities. Our approach is based on a contrastive learning framework that couples contrastive language-image pretraining with an image-tabular matching module, to better align multimodal data representations in a shared latent space. The model is trained on the UK Biobank, which includes structural brain MRI and clinical data. We benchmark its performance against state-of-the-art unimodal and multimodal methods using tabular, image, and image-tabular combinations under diverse frozen and trainable model settings. The proposed model outperformed self-supervised tabular (image) methods by 2.6% (2.6%) in ROC-AUC and by 3.3% (5.6%) in balanced accuracy. Additionally, it showed a 7.6% increase in balanced accuracy compared to the best multimodal supervised model. Through interpretable tools, our approach demonstrated better integration of tabular and image data, providing richer and more aligned embeddings. Gradient-weighted Class Activation Mapping heatmaps further revealed activated brain regions commonly associated in the literature with brain aging, stroke risk, and clinical outcomes. This robust self-supervised multimodal framework surpasses state-of-the-art methods for stroke risk prediction and offers a strong foundation for future studies integrating diverse data modalities to advance clinical predictive modelling.
Abstract:Accurate prediction of cardiovascular diseases remains imperative for early diagnosis and intervention, necessitating robust and precise predictive models. Recently, there has been a growing interest in multi-modal learning for uncovering novel insights not available through uni-modal datasets alone. By combining cardiac magnetic resonance images, electrocardiogram signals, and available medical information, our approach enables the capture of holistic status about individuals' cardiovascular health by leveraging shared information across modalities. Integrating information from multiple modalities and benefiting from self-supervised learning techniques, our model provides a comprehensive framework for enhancing cardiovascular disease prediction with limited annotated datasets. We employ a masked autoencoder to pre-train the electrocardiogram ECG encoder, enabling it to extract relevant features from raw electrocardiogram data, and an image encoder to extract relevant features from cardiac magnetic resonance images. Subsequently, we utilize a multi-modal contrastive learning objective to transfer knowledge from expensive and complex modality, cardiac magnetic resonance image, to cheap and simple modalities such as electrocardiograms and medical information. Finally, we fine-tuned the pre-trained encoders on specific predictive tasks, such as myocardial infarction. Our proposed method enhanced the image information by leveraging different available modalities and outperformed the supervised approach by 7.6% in balanced accuracy.
Abstract:Early identification of stroke is crucial for intervention, requiring reliable models. We proposed an efficient retinal image representation together with clinical information to capture a comprehensive overview of cardiovascular health, leveraging large multimodal datasets for new medical insights. Our approach is one of the first contrastive frameworks that integrates graph and tabular data, using vessel graphs derived from retinal images for efficient representation. This method, combined with multimodal contrastive learning, significantly enhances stroke prediction accuracy by integrating data from multiple sources and using contrastive learning for transfer learning. The self-supervised learning techniques employed allow the model to learn effectively from unlabeled data, reducing the dependency on large annotated datasets. Our framework showed an AUROC improvement of 3.78% from supervised to self-supervised approaches. Additionally, the graph-level representation approach achieved superior performance to image encoders while significantly reducing pre-training and fine-tuning runtimes. These findings indicate that retinal images are a cost-effective method for improving cardiovascular disease predictions and pave the way for future research into retinal and cerebral vessel connections and the use of graph-based retinal vessel representations.