Accurate prediction of mortality in nasopharyngeal carcinoma (NPC), a complex malignancy particularly challenging in advanced stages, is crucial for optimizing treatment strategies and improving patient outcomes. However, this predictive process is often compromised by the high-dimensional and heterogeneous nature of NPC-related data, coupled with the pervasive issue of incomplete multi-modal data, manifesting as missing radiological images or incomplete diagnostic reports. Traditional machine learning approaches suffer significant performance degradation when faced with such incomplete data, as they fail to effectively handle the high-dimensionality and intricate correlations across modalities. Even advanced multi-modal learning techniques like Transformers struggle to maintain robust performance in the presence of missing modalities, as they lack specialized mechanisms to adaptively integrate and align the diverse data types, while also capturing nuanced patterns and contextual relationships within the complex NPC data. To address these problem, we introduce IMAN: an adaptive network for robust NPC mortality prediction with missing modalities.

Nasopharyngeal carcinoma (NPC) is one of the understudied yet deadliest cancers in South East Asia. In Malaysia, the prevalence is identified mainly in Sarawak, among the ethnic of Bidayuh. NPC is often late-diagnosed because it is asymptomatic at the early stage. There are several tissue representations from the nasopharynx biopsy, such as nasopharyngeal inflammation (NPI), lymphoid hyperplasia (LHP), nasopharyngeal carcinoma (NPC) and normal tissue. This paper is our first initiative to identify the difference between NPC, NPI and normal cases. Seven whole slide images (WSIs) with gigapixel resolutions from seven different patients and two hospitals were experimented with using two test setups, consisting of a different set of images. The tissue regions are patched into smaller blocks and classified using DenseNet architecture with 21 dense layers. Two tests are carried out, each for proof of concept (Test 1) and real-test scenario (Test 2). The accuracy achieved for NPC class is 94.8% for Test 1 and 67.0% for Test 2. Keywords: Deep learning, Densenet, Whole slide image, Digital pathology, Nasopharyngeal carcinoma.

Multi-modality magnetic resonance imaging data with various sequences facilitate the early diagnosis, tumor segmentation, and disease staging in the management of nasopharyngeal carcinoma (NPC). The lack of publicly available, comprehensive datasets limits advancements in diagnosis, treatment planning, and the development of machine learning algorithms for NPC. Addressing this critical need, we introduce the first comprehensive NPC MRI dataset, encompassing MR axial imaging of 277 primary NPC patients. This dataset includes T1-weighted, T2-weighted, and contrast-enhanced T1-weighted sequences, totaling 831 scans. In addition to the corresponding clinical data, manually annotated and labeled segmentations by experienced radiologists offer high-quality data resources from untreated primary NPC.

Bingxin Gu and Mingyuan Meng contributed equally to this work. Abstract Objective: Deep Learning-based Radiomics (DLR) has achieved great success in medical image analysis and has been considered as a replacement to conventional radiomics that relies on handcrafted features. In this study, we aimed to explore the capability of DLR for the prediction of 5-year Progression-Free Survival (PFS) in advanced Nasopharyngeal Carcinoma (NPC) using pretreatment PET/CT images. Methods: A total of 257 patients (170/87 patients in internal/external cohorts) with advanced NPC (TNM stage III or IVa) were enrolled. We developed an end-to-end multi-modality DLR model, in which a 3D convolutional neural network was optimized to extract deep features from pretreatment PET/CT images and predict the probability of 5-year PFS. TNM stage, as a high-level clinical feature, could be integrated into our DLR model to further improve the prognostic performance. For a comparison between conventional radiomics and DLR, 1456 handcrafted features were extracted, and optimal conventional radiomics methods were selected from 54 cross-combinations of 6 feature selection methods and 9 classification methods. In addition, risk group stratification was performed with clinical signature, conventional radiomics signature, and DLR signature. Results: Our multi-modality DLR model using both PET and CT achieved higher prognostic performance (AUC = 0.842 0.034 and 0.823 0.012 for the internal and external cohorts) than the optimal conventional radiomics method (AUC = 0.796 0.033 and 0.782 0.012). Furthermore, the multi-modality DLR model outperformed single-modality DLR models using only PET (AUC = 0.818 0.029 and 0.796 0.009) or only CT (AUC = 0.657 0.055 and 0.645 0.021). For risk group stratification, the conventional radiomics signature and DLR signature enabled significant difference between the high-and low-risk patient groups in the both internal and external cohorts (P < 0.001), while the clinical signature failed in the external cohort (P = 0.177).

Apart from its distinct epidemiology, the natural behavior, treatment, and prognosis are different from other head and neck cancers. With the growing trend of artificial intelligence (AI), especially deep learning (DL), in head and neck cancer care, we sought to explore the unique clinical application and implementation direction of AI in the management of NPC. Methods: The search protocol was performed to collect publications using AI, machine learning (ML) and DL in NPC management from PubMed, Scopus and Embase. The articles were filtered using inclusion and exclusion criteria, and the quality of the papers was assessed. Data were extracted from the finalized articles.

We present a PaperRobot who performs as an automatic research assistant by (1) conducting deep understanding of a large collection of human-written papers in a target domain and constructing comprehensive background knowledge graphs (KGs); (2) creating new ideas by predicting links from the background KGs, by combining graph attention and contextual text attention; (3) incrementally writing some key elements of a new paper based on memory-attention networks: from the input title along with predicted related entities to generate a paper abstract, from the abstract to generate conclusion and future work, and finally from future work to generate a title for a follow-on paper. Turing Tests, where a biomedical domain expert is asked to compare a system output and a human-authored string, show PaperRobot generated abstracts, conclusion and future work sections, and new titles are chosen over human-written ones up to 30%, 24% and 12% of the time, respectively.