The rapidly emerging field of deep learning-based computational pathology has shown promising results in utilizing whole slide images (WSIs) to objectively prognosticate cancer patients. However, most prognostic methods are currently limited to either histopathology or genomics alone, which inevitably reduces their potential to accurately predict patient prognosis. Whereas integrating WSIs and genomic features presents three main challenges: (1) the enormous heterogeneity of gigapixel WSIs which can reach sizes as large as 150,000x150,000 pixels; (2) the absence of a spatially corresponding relationship between histopathology images and genomic molecular data; and (3) the existing early, late, and intermediate multimodal feature fusion strategies struggle to capture the explicit interactions between WSIs and genomics. To ameliorate these issues, we propose the Mutual-Guided Cross-Modality Transformer (MGCT), a weakly-supervised, attention-based multimodal learning framework that can combine histology features and genomic features to model the genotype-phenotype interactions within the tumor microenvironment. To validate the effectiveness of MGCT, we conduct experiments using nearly 3,600 gigapixel WSIs across five different cancer types sourced from The Cancer Genome Atlas (TCGA). Extensive experimental results consistently emphasize that MGCT outperforms the state-of-the-art (SOTA) methods.

基于深度学习的计算病理学领域的研究表明，利用全切片图像（WSIs）客观预测癌症患者预后的效果显著。然而，目前大多数预后方法局限于组织病理学或基因组学，不可避免地降低了其准确预测患者预后的潜力。为了解决这些问题，我们提出了一种弱监督、基于注意机制的多模态学习框架——互相引导的跨模态转换器（MGCT），可以利用组织学特征和基因组特征来建模肿瘤微环境内的基因型-表型相互作用。通过使用来自癌症基因组图谱（TCGA）的五种不同癌症类型的近3600个Gigapixel WSIs进行实验，广泛的实验结果一致表明MGCT优于现有的最先进方法（SOTA）。

MGCT: 基于综合组织病理学-基因组特征的生存结局预测的互相引导的跨模态变换器