Foundation model for cancer imaging biomarkers.

Foundation models in deep learning are characterized by a single large-scale model trained on vast amounts of data serving as the foundation for various downstream tasks. Foundation models are generally trained using self-supervised learning and excel in reducing the demand for training samples in downstream applications. This is especially important in medicine, where large labelled datasets are often scarce. Here, we developed a foundation model for cancer imaging biomarker discovery by training a convolutional encoder through self-supervised learning using a comprehensive dataset of 11,467 radiographic lesions. The foundation model was evaluated in distinct and clinically relevant applications of cancer imaging-based biomarkers. We found that it facilitated better and more efficient learning of imaging biomarkers and yielded task-specific models that significantly outperformed conventional supervised and other state-of-the-art pretrained implementations on downstream tasks, especially when training dataset sizes were very limited. Furthermore, the foundation model was more stable to input variations and showed strong associations with underlying biology. Our results demonstrate the tremendous potential of foundation models in discovering new imaging biomarkers that may extend to other clinical use cases and can accelerate the widespread translation of imaging biomarkers into clinical settings.

Decoding biological age from face photographs using deep learning.

Because humans age at different rates, a person's physical appearance may yield insights into their biological age and physiological health more reliably than their chronological age. In medicine, however, appearance is incorporated into medical judgments in a subjective and non-standardized fashion. In this study, we developed and validated FaceAge, a deep learning system to estimate biological age from easily obtainable and low-cost face photographs. FaceAge was trained on data from 58,851 healthy individuals, and clinical utility was evaluated on data from 6,196 patients with cancer diagnoses from two institutions in the United States and The Netherlands. To assess the prognostic relevance of FaceAge estimation, we performed Kaplan Meier survival analysis. To test a relevant clinical application of FaceAge, we assessed the performance of FaceAge in end-of-life patients with metastatic cancer who received palliative treatment by incorporating FaceAge into clinical prediction models. We found that, on average, cancer patients look older than their chronological age, and looking older is correlated with worse overall survival. FaceAge demonstrated significant independent prognostic performance in a range of cancer types and stages. We found that FaceAge can improve physicians' survival predictions in incurable patients receiving palliative treatments, highlighting the clinical utility of the algorithm to support end-of-life decision-making. FaceAge was also significantly associated with molecular mechanisms of senescence through gene analysis, while age was not. These findings may extend to diseases beyond cancer, motivating using deep learning algorithms to translate a patient's visual appearance into objective, quantitative, and clinically useful measures.

Foundation Models for Quantitative Biomarker Discovery in Cancer Imaging.

Foundation models represent a recent paradigm shift in deep learning, where a single large-scale model trained on vast amounts of data can serve as the foundation for various downstream tasks. Foundation models are generally trained using self-supervised learning and excel in reducing the demand for training samples in downstream applications. This is especially important in medicine, where large labeled datasets are often scarce. Here, we developed a foundation model for imaging biomarker discovery by training a convolutional encoder through self-supervised learning using a comprehensive dataset of 11,467 radiographic lesions. The foundation model was evaluated in distinct and clinically relevant applications of imaging-based biomarkers. We found that they facilitated better and more efficient learning of imaging biomarkers and yielded task-specific models that significantly outperformed their conventional supervised counterparts on downstream tasks. The performance gain was most prominent when training dataset sizes were very limited. Furthermore, foundation models were more stable to input and inter-reader variations and showed stronger associations with underlying biology. Our results demonstrate the tremendous potential of foundation models in discovering novel imaging biomarkers that may extend to other clinical use cases and can accelerate the widespread translation of imaging biomarkers into clinical settings.