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Beyond unimodal analysis: multimodal ensemble learning for enhanced assessment of atherosclerotic disease progression
Research Unit of Artificial Intelligence and Computer Systems, Department of Engineering, Università Campus Bio-Medico di Roma, Rome, Italy.
Umeå University, Faculty of Medicine, Department of Diagnostics and Intervention.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.ORCID iD: 0000-0003-4100-8298
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.ORCID iD: 0000-0002-1617-6102
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2025 (English)In: Computerized Medical Imaging and Graphics, ISSN 0895-6111, E-ISSN 1879-0771, Vol. 124, article id 102617Article in journal (Refereed) Published
Abstract [en]

Atherosclerosis is a leading cardiovascular disease typified by fatty streaks accumulating within arterial walls, culminating in potential plaque ruptures and subsequent strokes. Existing clinical risk scores, such as systematic coronary risk estimation and Framingham risk score, profile cardiovascular risks based on factors like age, cholesterol, and smoking, among others. However, these scores display limited sensitivity in early disease detection. Parallelly, ultrasound-based risk markers, such as the carotid intima media thickness, while informative, only offer limited predictive power. Notably, current models largely focus on either ultrasound image-derived risk markers or clinical risk factor data without combining both for a comprehensive, multimodal assessment. This study introduces a multimodal ensemble learning framework to assess atherosclerosis severity, especially in its early sub-clinical stage. We utilize a multi-objective optimization targeting both performance and diversity, aiming to integrate features from each modality effectively. Our objective is to measure the efficacy of models using multimodal data in assessing vascular aging, i.e., plaque presence and vascular age, over a six-year period. We also delineate a procedure for optimal model selection from a vast pool, focusing on best-suited models for classification tasks. Additionally, through eXplainable Artificial Intelligence techniques, this work delves into understanding key model contributors and discerning unique subject subgroups.

Place, publisher, year, edition, pages
Elsevier, 2025. Vol. 124, article id 102617
Keywords [en]
Atherosclerosis, Cardiovascular disease, Clinical risk scores, Plaque prediction, Ultrasound imaging, Vascular age prediction, XAI
National Category
Cardiology and Cardiovascular Disease
Identifiers
URN: urn:nbn:se:umu:diva-243075DOI: 10.1016/j.compmedimag.2025.102617ISI: 001547331700001PubMedID: 40779964Scopus ID: 2-s2.0-105012580632OAI: oai:DiVA.org:umu-243075DiVA, id: diva2:1993410
Available from: 2025-08-29 Created: 2025-08-29 Last updated: 2025-08-29Bibliographically approved

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Bertgren, AmandaNäslund, UlfWennberg, PatrikSoda, PaoloGrönlund, Christer

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Bertgren, AmandaNäslund, UlfWennberg, PatrikSoda, PaoloGrönlund, Christer
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