diagnosis and prognosis

诊断和预后
  • 文章类型: Journal Article
    心血管疾病(CVD)发病率的增加是一个重要的全球健康问题,每年影响数百万人。急性CVD的准确诊断提出了巨大的挑战,误诊可显著降低患者生存率。传统的生物标志物在心血管疾病的诊断和预后中起着至关重要的作用,但是它们会受到各种因素的影响,比如年龄,性别,和肾功能。可溶性ST2(sST2)是一种与不同CVD密切相关的新型生物标志物。其低参考变化值使其适合连续测量,不受年龄影响,肾功能,和其他混杂因素,促进心血管疾病的风险分层。此外,sST2与其他生物标志物的结合可提高诊断准确性和预后价值.本综述旨在对sST2进行全面概述,重点介绍其作为不同类型CVD的心肌标志物的诊断和预后价值,并讨论sST2目前的局限性。
    The increasing incidence of cardiovascular disease (CVD) is a significant global health concern, affecting millions of individuals each year. Accurate diagnosis of acute CVD poses a formidable challenge, as misdiagnosis can significantly decrease patient survival rates. Traditional biomarkers have played a vital role in the diagnosis and prognosis of CVDs, but they can be influenced by various factors, such as age, sex, and renal function. Soluble ST2 (sST2) is a novel biomarker that is closely associated with different CVDs. Its low reference change value makes it suitable for continuous measurement, unaffected by age, kidney function, and other confounding factors, facilitating risk stratification of CVDs. Furthermore, the combination of sST2 with other biomarkers can enhance diagnostic accuracy and prognostic value. This review aims to provide a comprehensive overview of sST2, focusing on its diagnostic and prognostic value as a myocardial marker for different types of CVDs and discussing the current limitations of sST2.
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  • 文章类型: Journal Article
    非小细胞肺癌(NSCLC),包括肺鳞状细胞癌(LUSC)和肺腺癌(LUAD)亚型,是一种恶性肿瘤类型,5年生存率低。识别新的强大的诊断生物标志物,预后生物标志物,和NSCLC的潜在治疗靶点是迫切需要的。
    UCSCXena,UALCAN,和GEO数据库用于筛选和分析差异表达基因,监管模式,非小细胞肺癌的遗传/表观遗传改变。UCSCXena数据库,GEO数据库,组织微阵列,和免疫组织化学染色分析用于评估诊断和预后价值。进行功能增益测定以检查作用。估计,TIMER,链接的组学,STRING,和DAVID算法用于分析潜在的分子机制。
    NR3C2被鉴定为NSCLC中潜在的重要分子。NR3C2在NSCLC中低水平表达,LUAD,和LUSC组织,这与这些患者的临床指标显着相关。受试者工作特征曲线分析提示NR3C2表达模式改变对NSCLC有诊断价值,LUAD,尤其是LUSC患者。NR3C2表达水平的降低可以帮助预测NSCLC和LUAD患者的不良预后,而不是LUSC患者。这些结果已通过数据库分析和组织微阵列上的真实世界临床样品得到证实。拷贝数变异有助于NSCLC和LUAD中NR3C2的低表达水平,而启动子DNA甲基化参与其在LUSC中的下调。两个NR3C2启动子甲基化位点对LUSC诊断具有较高的敏理性和特异性,具有临床运用潜力。NR3C2可能是NSCLC发生发展的关键参与者,与肿瘤微环境和免疫细胞浸润密切相关。NR3C2共表达的基因参与许多癌症相关的信号通路,进一步支持NR3C2在NSCLC中的潜在重要作用。
    NR3C2是一种新的NSCLC潜在的诊断和预后生物标志物和治疗靶点。
    UNASSIGNED: Non-small cell lung cancer (NSCLC), including the lung squamous cell carcinoma (LUSC) and lung adenocarcinoma (LUAD) subtypes, is a malignant tumor type with a poor 5-year survival rate. The identification of new powerful diagnostic biomarkers, prognostic biomarkers, and potential therapeutic targets in NSCLC is urgently required.
    UNASSIGNED: The UCSC Xena, UALCAN, and GEO databases were used to screen and analyze differentially expressed genes, regulatory modes, and genetic/epigenetic alterations in NSCLC. The UCSC Xena database, GEO database, tissue microarray, and immunohistochemistry staining analyses were used to evaluate the diagnostic and prognostic values. Gain-of-function assays were performed to examine the roles. The ESTIMATE, TIMER, Linked Omics, STRING, and DAVID algorithms were used to analyze potential molecular mechanisms.
    UNASSIGNED: NR3C2 was identified as a potentially important molecule in NSCLC. NR3C2 is expressed at low levels in NSCLC, LUAD, and LUSC tissues, which is significantly related to the clinical indexes of these patients. Receiver operating characteristic curve analysis suggests that the altered NR3C2 expression patterns have diagnostic value in NSCLC, LUAD, and especially LUSC patients. Decreased NR3C2 expression levels can help predict poor prognosis in NSCLC and LUAD patients but not in LUSC patients. These results have been confirmed both with database analysis and real-world clinical samples on a tissue microarray. Copy number variation contributes to low NR3C2 expression levels in NSCLC and LUAD, while promoter DNA methylation is involved in its downregulation in LUSC. Two NR3C2 promoter methylation sites have high sensitivity and specificity for LUSC diagnosis with clinical application potential. NR3C2 may be a key participant in NSCLC development and progression and is closely associated with the tumor microenvironment and immune cell infiltration. NR3C2 co-expressed genes are involved in many cancer-related signaling pathways, further supporting a potentially significant role of NR3C2 in NSCLC.
    UNASSIGNED: NR3C2 is a novel potential diagnostic and prognostic biomarker and therapeutic target in NSCLC.
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  • 文章类型: Journal Article
    肝细胞癌(HCC)是世界上癌症相关死亡的重要原因。HCC的发生发展与非编码RNA(ncRNAs)的异常调控密切相关,如microRNAs(miRNAs),长链非编码RNA(lncRNA),和环状RNAs(circRNAs)。癌症生物学中的重要生物学途径,如细胞增殖,死亡,和转移,受到这些ncRNAs的影响,调节基因表达。非编码RNA在HCC中的异常表达增加了它们作为新的生物标志物用于诊断的可能性。预后,和治疗目标。此外,通过控制癌症相关基因的表达,miRNA可以作为肿瘤抑制因子或癌基因发挥作用。另一方面,lncRNAs通过与细胞内的其他分子相互作用在癌症的发展中发挥作用,which,反过来,影响染色质重塑等过程,转录,和转录后过程。目前的研究强调了ncRNA驱动的调控系统在HCC中的重要性,这揭示了肿瘤的行为和治疗反应。这项研究强调了ncRNAs通过使用精准医学方法来增强目前的HCC护理方法,从而在这种困难的疾病环境中改善患者预后的巨大潜力。
    Hepatocellular carcinoma (HCC) is a significant contributor to cancer-related deaths in the world. The development and progression of HCC are closely correlated with the abnormal regulation of non-coding RNAs (ncRNAs), such as microRNAs (miRNAs), long non-coding RNAs (lncRNAs), and circular RNAs (circRNAs). Important biological pathways in cancer biology, such as cell proliferation, death, and metastasis, are impacted by these ncRNAs, which modulate gene expression. The abnormal expression of non-coding RNAs in HCC raises the possibility that they could be applied as new biomarkers for diagnosis, prognosis, and treatment targets. Furthermore, by controlling the expression of cancer-related genes, miRNAs can function as either tumor suppressors or oncogenes. On the other hand, lncRNAs play a role in the advancement of cancer by interacting with other molecules within the cell, which, in turn, affects processes such as chromatin remodeling, transcription, and post-transcriptional processes. The importance of ncRNA-driven regulatory systems in HCC is being highlighted by current research, which sheds light on tumor behavior and therapy response. This research highlights the great potential of ncRNAs to improve patient outcomes in this difficult disease landscape by augmenting the present methods of HCC care through the use of precision medicine approaches.
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  • 文章类型: Journal Article
    神经母细胞瘤(NB)是最常见的颅外实体儿科癌症,是儿童癌症相关死亡的主要原因之一。尽管目前的多模式治疗方案,大多数晚期NBs患者出现治疗抗性和复发,导致不良的疾病结果。关于小细胞外囊泡(EV)在多种癌症类型的进展和转移中的病理生理学作用,然而,电动汽车在NB中的重要性直到最近才被很好地理解。最近几年出现的研究表明,电动汽车参与了NB发病机制的各个方面。在这篇综述中,我们总结了电动汽车在NB进展中的作用的最新发现和进展。如肿瘤生长,转移和治疗抗性,这可能有助于未来NBEV研究的研究。我们还讨论了NB-EV治疗靶向的不同策略以及NB-EV作为潜在生物标志物的利用。
    Neuroblastoma (NB) is the most common extracranial solid pediatric cancer, and is one of the leading causes of cancer-related deaths in children. Despite the current multi-modal treatment regimens, majority of patients with advanced-stage NBs develop therapeutic resistance and relapse, leading to poor disease outcomes. There is a large body of knowledge on pathophysiological role of small extracellular vesicles (EVs) in progression and metastasis of multiple cancer types, however, the importance of EVs in NB was until recently not well understood. Studies emerging in the last few years have demonstrated the involvement of EVs in various aspects of NB pathogenesis. In this review we summarize these recent findings and advances on the role EVs play in NB progression, such as tumor growth, metastasis and therapeutic resistance, that could be helpful for future investigations in NB EV research. We also discuss different strategies for therapeutic targeting of NB-EVs as well as utilization of NB-EVs as potential biomarkers.
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  • 文章类型: Journal Article
    目标:超越三种常规多模态融合策略的不足(即,input-,功能和输出级融合),我们提出了一种双向注意力感知的流体金字塔特征集成融合网络(BAF-Net),具有跨模态交互功能,用于多模态医学图像诊断和预后。&#xD;方法:BAF-Net由两个相同的分支组成,以保留单峰特征和一个双向注意力感知的蒸馏流,以逐步吸收跨模态补充并学习自下而上和自上而下的补充特征。采用流体金字塔连接来集成网络不同级别的分层特征,和渠道方面的注意力模块被用来减轻跨模式跨级别的不兼容性。此外,引入了深度可分离卷积来融合跨模态跨级别特征,以在很大程度上缓解参数的增加。根据两个临床任务评估了BAF-Net的泛化能力:(1)内部PET-CT数据集,包括174名患者,用于区分肺癌和肺结核。(2)公共多中心PET-CT头颈癌数据集,来自9个中心的800名患者进行总体生存预测。 主要结果:在LC-PTB数据集上,与输入级融合模型(AUC=0.6825;p<0.05)相比,BAF-Net(AUC=0.7342)的性能有所改善,特征级融合模型(AUC=0.6968;p=0.0547),输出级融合模型(AUC=0.7011;p<0.05)。在H&N癌症数据集上,BAF-Net(C-index=0.7241)优于输入-,feature-,和输出级融合模型,2.95%,3.77%,和1.52%的C指数增量(分别为p=0.3336、0.0479和0.2911)。消融实验证明了所有设计模块在两个数据集中关于所有评估指标的有效性。&#xD;意义:在两个数据集上进行的大量实验表明,BAF-Net在诊断和预后方面比三种常规融合策略和PET或CT单峰网络具有更好的性能和鲁棒性。
    Objective. To go beyond the deficiencies of the three conventional multimodal fusion strategies (i.e. input-, feature- and output-level fusion), we propose a bidirectional attention-aware fluid pyramid feature integrated fusion network (BAF-Net) with cross-modal interactions for multimodal medical image diagnosis and prognosis.Approach. BAF-Net is composed of two identical branches to preserve the unimodal features and one bidirectional attention-aware distillation stream to progressively assimilate cross-modal complements and to learn supplementary features in both bottom-up and top-down processes. Fluid pyramid connections were adopted to integrate the hierarchical features at different levels of the network, and channel-wise attention modules were exploited to mitigate cross-modal cross-level incompatibility. Furthermore, depth-wise separable convolution was introduced to fuse the cross-modal cross-level features to alleviate the increase in parameters to a great extent. The generalization abilities of BAF-Net were evaluated in terms of two clinical tasks: (1) an in-house PET-CT dataset with 174 patients for differentiation between lung cancer and pulmonary tuberculosis. (2) A public multicenter PET-CT head and neck cancer dataset with 800 patients from nine centers for overall survival prediction.Main results. On the LC-PTB dataset, improved performance was found in BAF-Net (AUC = 0.7342) compared with input-level fusion model (AUC = 0.6825;p< 0.05), feature-level fusion model (AUC = 0.6968;p= 0.0547), output-level fusion model (AUC = 0.7011;p< 0.05). On the H&N cancer dataset, BAF-Net (C-index = 0.7241) outperformed the input-, feature-, and output-level fusion model, with 2.95%, 3.77%, and 1.52% increments of C-index (p= 0.3336, 0.0479 and 0.2911, respectively). The ablation experiments demonstrated the effectiveness of all the designed modules regarding all the evaluated metrics in both datasets.Significance. Extensive experiments on two datasets demonstrated better performance and robustness of BAF-Net than three conventional fusion strategies and PET or CT unimodal network in terms of diagnosis and prognosis.
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  • 文章类型: Journal Article
    背景头颈部鳞状细胞癌(HNSCC)是一种突出的全球癌症,表现在口腔等不同部位。口咽,还有喉部.人乳头瘤病毒(HPV)感染和遗传改变有助于HNSCC的发展。目的探讨乳腺癌扩增序列(BCAS3)在HNSCC发病中的复杂作用。方法我们使用多个数据库,使用癌症基因组图谱-头颈部鳞状细胞癌(TCGA-HNSC)数据集分析HNSCC中BCAS3的表达,并使用逆转录定量聚合酶链反应(RT-qPCR)在口腔鳞状细胞癌(OSCC)中进行验证。分析BCAS3基因和蛋白质网络以鉴定其功能通路。结果结果显示在HNSCC和OSCC肿瘤中观察到BCAS3的显著过表达。我们的研究探讨了BCAS3与临床病理特征和患者预后的相关性,表明它参与了肿瘤的侵袭性。值得注意的是,HPV阳性和HPV阴性HNSCC样品中的BCAS3表达强调了复杂的病毒相互作用。Kaplan-Meier图显示BCAS3对患者生存的影响。此外,发现BCAS3与肿瘤免疫浸润和自噬之间的关联。结论我们的研究有助于理解BCAS3在HNSCC中的作用,并表明其作为这些恶性肿瘤的治疗靶标和诊断标志物的潜力。
    Background Head and neck squamous cell carcinoma (HNSCC) is a prominent global cancer that manifests across diverse sites such as the oral cavity, oropharynx, and larynx. Human papillomavirus (HPV) infection and genetic alterations contribute to HNSCC development. Objective To investigate the complex role of breast carcinoma amplified sequence (BCAS3) in HNSCC pathogenesis. Methods We used multiple databases to analyze BCAS3 expression in HNSCC using The Cancer Genome Atlas-Head-Neck Squamous Cell Carcinoma (TCGA-HNSC) dataset and validated it in oral squamous cell carcinoma (OSCC) using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). The BCAS3 gene and protein networks were analyzed to identify their functional pathways. Results The results revealed significant overexpression of BCAS3 was observed in HNSCC and OSCC tumors. Our study explores BCAS3\'s correlation with clinicopathological features and patient prognosis, suggesting its involvement in tumor aggressiveness. Notably, BCAS3 expression in HPV-positive and HPV-negative HNSCC samples emphasizes the intricate viral interactions. Kaplan-Meier plots demonstrate BCAS3\'s impact on patient survival. Furthermore, BCAS3\'s association between tumor immune infiltration and autophagy was uncovered. Conclusion Our study contributes to the understanding of BCAS3\'s role in HNSCC and suggests its potential as a therapeutic target and diagnostic marker for these malignancies.
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  • 文章类型: Journal Article
    内部膨胀反应(ISR)是影响全球基础设施耐久性的最关键的恶化机制之一。虽然已经广泛探索了新结构的预防措施,诊断和预测ISR影响结构的有效方案,尤其是在他们的早期阶段,仍然需要。因此,通过全面的文献计量分析,这项研究的重点是探索评估和预测混凝土结构中ISR损伤的演变和当前方法。为了诊断,从具体岩石学和无损技术(NDT)向更全面的方法(即,多级评估),并观察到刚度损伤测试(SDT)和损伤等级指数(DRI)。此外,它确定了残余膨胀和孔隙溶液分析的有价值的输入作为预后的相关参数。基于这些发现,提出了一个结构化的管理框架,旨在完善受ISR影响的基础设施的诊断和预后过程,最终有助于改善长期结构健康和维护策略。
    Internal swelling reactions (ISRs) are among the most critical deterioration mechanisms affecting infrastructure\'s durability worldwide. While preventative measures for new structures have been extensively explored, effective protocols for diagnosing and prognosing ISR-affected structures, especially at their early stages, are still required. Therefore, through a comprehensive bibliometric analysis, this study focuses on exploring the evolution and current methods for assessing and forecasting ISR damage in concrete structures. For diagnosis, a shift from concrete petrography and non-destructive techniques (NDTs) towards more comprehensive methods (i.e., multi-level assessment) with the stiffness damage test (SDT) and damage rating index (DRI) is observed. Moreover, it identifies the valuable inputs from residual expansion and pore solution analysis as relevant parameters for prognosis. Based on these findings, a structured management framework is proposed aiming to refine the diagnosis and prognosis processes of ISR-affected infrastructure, ultimately contributing to improved long-term structural health and maintenance strategies.
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  • 文章类型: Journal Article
    分析肺部超声评分(LUS)联合血清炎症指标在不同严重程度重症肺炎中的意义及对预后的临床价值。
    选取2017年6月至2021年6月甘肃省人民医院收治的100例重症肺炎患者作为研究对象。根据急性生理和慢性健康(APACHEII)评分,他们被分为低风险组(28例),中危组(39例)和高危组(33例)。患者的一般临床资料(年龄、性别,吸烟史,和潜在疾病)被收集,测量患者的肺部超声评分(LUS),和血清炎症指标(IL-6,IL-10,TNF-α,CRP和NLR)水平;Pearson相关性分析评价LUS评分、血清炎症指标水平与病情严重程度的关系;受试者工作特征(ROC)曲线分析,评价LUS评分与血清炎症指标联合诊断对重症肺炎病情严重程度的预后价值。
    随着重症肺炎严重程度的增加,LUS评分和体内炎症水平持续升高,LUS联合血清炎症指标可区分低危,中危和高危重症肺炎具有较高的诊断价值。此外,LUS和血清炎症标志物的联合诊断也与重症肺炎患者的预后密切相关,可以区分预后。
    LUS联合血清炎症指标(IL-6,IL-10,TNF-α,CRP和NLR)可以鉴别重症肺炎的严重程度和预后,这可能是诊断重症肺炎和指导早期临床干预的新方向。
    UNASSIGNED: To analyze the significance of lung ultrasound score (LUS) combined with serum inflammatory indexes in different severities of severe pneumonia and its clinical value on prognosis.
    UNASSIGNED: 100 patients with severe pneumonia treated in the Gansu Provincial Hospital from June 2017 to June 2021 were selected as the research objects. According to the acute physiology and chronic health (APACHE II) score, they were divided into a low-risk group (28 cases), a medium-risk group (39 cases) and a high-risk group (33 cases). The general clinical data of the patients (age, gender, smoking history, and underlying diseases) were collected, the lung ultrasound score (LUS) of the patients was measured, and the serum inflammatory indicators (IL-6, IL-10, TNF-α, CRP and NLR) levels; Pearson correlation analysis to evaluate the correlation between LUS score, serum inflammatory index levels and disease severity; receiver operating characteristic (ROC) curve analysis to evaluate the prognostic value of the combined diagnosis of LUS score and serum inflammatory index for the severity of severe pneumonia.
    UNASSIGNED: With the increase in the severity of severe pneumonia, the LUS score and the level of inflammation in the body continued to increase, and LUS combined with serum inflammatory indexes could distinguish the severity of low-risk, medium-risk and high-risk severe pneumonia and had high diagnostic value. In addition, the combined diagnosis of LUS and serum inflammatory markers is also closely related to the prognosis of patients with severe pneumonia, which can distinguish the prognosis.
    UNASSIGNED: LUS combined with serum inflammatory indicators (IL-6, IL-10, TNF-α, CRP and NLR) can differentiate the severity and prognosis of severe pneumonia, which may be a new direction for diagnosing severe pneumonia and guide early clinical intervention.
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  • 文章类型: Journal Article
    膀胱癌是全球最普遍的癌症之一,并且在晚期阶段与高死亡率相关。其检测依赖于对患者不愉快的侵入性诊断方法。非侵入性分子生物标志物,如miRNA,可以作为这种恶性肿瘤的早期发现和预后的替代方法。我们设计了一种结合转录组分析的计算方法,生存分析,和诊断能力的计算,以便分离具有高诊断和预后效用的miRNA特征。我们对来自429名患者的TCGA-BLCA数据的分析产生了一个miRNA特征,由五个上调和三个下调的miRNA组成,其累积诊断能力优于当前的诊断方法。相同的miRNA具有强烈的预后意义,因为它们的表达与膀胱癌患者的总体存活相关。我们评估了该特征在19种实体癌类型中的表达,支持其对膀胱癌的独特诊断效用。我们提供了关于这种miRNA特征在细胞周期调控中的功能意义的计算证据。证明了它在体液中的丰富,包括外周血和尿液。我们的研究表征了一种新的miRNA特征,具有作为膀胱癌诊断和预后的非侵入性方法的潜力。
    Bladder carcinoma is globally among the most prevalent cancers and is associated with a high mortality rate at advanced stages. Its detection relies on invasive diagnostic methods that are unpleasant for the patient. Non-invasive molecular biomarkers, such as miRNAs, could serve as alternatives for early detection and prognosis of this malignancy. We designed a computational approach that combines transcriptome profiling, survival analyses, and calculation of diagnostic power in order to isolate miRNA signatures with high diagnostic and prognostic utility. Our analysis of TCGA-BLCA data from 429 patients yielded one miRNA signature, consisting of five upregulated and three downregulated miRNAs with cumulative diagnostic power that outperforms current diagnostic methods. The same miRNAs have a strong prognostic significance since their expression is associated with the overall survival of bladder cancer patients. We evaluated the expression of this signature in 19 solid cancer types, supporting its unique diagnostic utility for bladder carcinoma. We provide computational evidence regarding the functional implications of this miRNA signature in cell cycle regulation, demonstrating its abundance in body fluids, including peripheral blood and urine. Our study characterized a novel miRNA signature with the potential to serve as a non-invasive method for bladder cancer diagnosis and prognosis.
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  • 文章类型: Journal Article
    医疗领域诊断技术的快速发展对医师处理和整合异构、但在常规练习中产生的补充数据。例如,单个癌症患者的个性化诊断和治疗计划依赖于各种图像(例如放射学,病理学和相机图像)和非图像数据(例如临床数据和基因组数据)。然而,这种决策程序可能是主观的,定性,并且具有很大的主体间变异性。随着多模式深度学习技术的最新进展,越来越多的努力已经致力于一个关键问题:我们如何提取和聚合多模态信息,最终提供更客观,定量计算机辅助临床决策?本文回顾了有关处理此类问题的最新研究。简而言之,这篇综述将包括(A)当前多模式学习工作流程的概述,(B)多模态融合方法的总结,(c)关于业绩的讨论,(d)在疾病诊断和预后中的应用,(e)挑战和未来方向。
    The rapid development of diagnostic technologies in healthcare is leading to higher requirements for physicians to handle and integrate the heterogeneous, yet complementary data that are produced during routine practice. For instance, the personalized diagnosis and treatment planning for a single cancer patient relies on various images (e.g. radiology, pathology and camera images) and non-image data (e.g. clinical data and genomic data). However, such decision-making procedures can be subjective, qualitative, and have large inter-subject variabilities. With the recent advances in multimodal deep learning technologies, an increasingly large number of efforts have been devoted to a key question: how do we extract and aggregate multimodal information to ultimately provide more objective, quantitative computer-aided clinical decision making? This paper reviews the recent studies on dealing with such a question. Briefly, this review will include the (a) overview of current multimodal learning workflows, (b) summarization of multimodal fusion methods, (c) discussion of the performance, (d) applications in disease diagnosis and prognosis, and (e) challenges and future directions.
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