Memory-Augmented Incomplete Multimodal Survival Prediction via Cross-Slide and Gene-Attentive Hypergraph Learning

Multimodal pathology-genomic analysis is critical for cancer survival prediction. However, existing approaches predominantly integrate formalin-fixed paraffin-embedded (FFPE) slides with genomic data, while neglecting the availability of other preservation slides, such as Fresh Froze (FF) slides. Moreover, as the high-resolution spatial nature of pathology data tends to dominate the cross-modality fusion process, it hinders effective multimodal fusion and leads to modality imbalance challenges between pathology and genomics. These methods also typically require complete data modalities, limiting their clinical applicability with incomplete modalities, such as missing either pathology or genomic data. In this paper, we propose a multimodal survival prediction framework that leverages hypergraph learning to effectively integrate multi-WSI information and cross-modality interactions between pathology slides and genomics data while addressing modality imbalance. In addition, we introduce a memory mechanism that stores previously learned paired pathology-genomic features and dynamically compensates for incomplete modalities. Experiments on five TCGA datasets demonstrate that our model outperforms advanced methods by over 2.3% in C-Index. Under incomplete modality scenarios, our approach surpasses pathology-only (3.3%) and gene-only models (7.9%). Code: https://github.com/MCPathology/M2Surv

Multimodal Cancer Survival Analysis via Hypergraph Learning with Cross-Modality Rebalance

Multimodal pathology-genomic analysis has become increasingly prominent in cancer survival prediction. However, existing studies mainly utilize multi-instance learning to aggregate patch-level features, neglecting the information loss of contextual and hierarchical details within pathology images. Furthermore, the disparity in data granularity and dimensionality between pathology and genomics leads to a significant modality imbalance. The high spatial resolution inherent in pathology data renders it a dominant role while overshadowing genomics in multimodal integration. In this paper, we propose a multimodal survival prediction framework that incorporates hypergraph learning to effectively capture both contextual and hierarchical details from pathology images. Moreover, it employs a modality rebalance mechanism and an interactive alignment fusion strategy to dynamically reweight the contributions of the two modalities, thereby mitigating the pathology-genomics imbalance. Quantitative and qualitative experiments are conducted on five TCGA datasets, demonstrating that our model outperforms advanced methods by over 3.4\% in C-Index performance.

Boundary-Guided Learning for Gene Expression Prediction in Spatial Transcriptomics

Spatial transcriptomics (ST) has emerged as an advanced technology that provides spatial context to gene expression. Recently, deep learning-based methods have shown the capability to predict gene expression from WSI data using ST data. Existing approaches typically extract features from images and the neighboring regions using pretrained models, and then develop methods to fuse this information to generate the final output. However, these methods often fail to account for the cellular structure similarity, cellular density and the interactions within the microenvironment. In this paper, we propose a framework named BG-TRIPLEX, which leverages boundary information extracted from pathological images as guiding features to enhance gene expression prediction from WSIs. Specifically, our model consists of three branches: the spot, in-context and global branches. In the spot and in-context branches, boundary information, including edge and nuclei characteristics, is extracted using pretrained models. These boundary features guide the learning of cellular morphology and the characteristics of microenvironment through Multi-Head Cross-Attention. Finally, these features are integrated with global features to predict the final output. Extensive experiments were conducted on three public ST datasets. The results demonstrate that our BG-TRIPLEX consistently outperforms existing methods in terms of Pearson Correlation Coefficient (PCC). This method highlights the crucial role of boundary features in understanding the complex interactions between WSI and gene expression, offering a promising direction for future research.