CHIMERA Challenge Task 2 and 3: Response Subtypes Classification and Progression Survival Prediction in Bladder Cancer Patients using Multimodal Datasets
Authors: Catherine Chia, Tongjie Wang, Robert Spaans, Maryam Mohammadlou, Farbod Khoraminia, J. Alberto Nakauma-González, Adam Kowalewski, Parandzem Khachatryan, +7 more
Abstract
High-risk non-muscle-invasive bladder cancer (HR-NMIBC) carries substantial risks of recurrence and progression, while current clinical risk stratification remains limited. CHIMERA was established as a multimodal AI challenge to benchmark prediction in HR-NMIBC under standardized evaluation. Task BRS predicts RNA-seq-defined BCG Response Subtypes from histopathology and structured clinicopathological data, whereas Task Progression models time-to-progression using histopathology, structured data, and RNA sequencing. A multimodal dataset of 368 patients was divided into public training and hidden validation and test sets. In total, 159 submissions were made, and 13 top-performing models were selected for benchmarking. The best models achieved a weighted F1 score of 0.73 for Task BRS and a C-index of 0.68 for Task Progression. Post-challenge analyses revealed task-dependent modality contributions, cohort-dependent performance degradation, and sensitivity to missing structured data. In Task BRS, histopathology partly compensated for pathology-derived structured variables, whereas progression models showed greater dependence on complementary inputs. Cross-model error analysis further identified patients that were consistently difficult across different architectures, with T1 substage associated with prediction difficulty. These findings highlight barriers to transportability and the importance of missingness-aware modeling and independent multi-institutional validation. CHIMERA provides a standardized multimodal benchmark for bladder cancer and a framework for studying not only model performance, but also robustness, information sufficiency, and patient-level prediction failure.
We propose a novel multimodal deep learning framework for patient-level survival prediction, which integrates whole-slide histology features, RNA-seq expression profiles, and clinical variables. Our architecture combines an ABMIL module~\cite{ilse2018attention} for slide-level representation with feedforward encoders for RNA and clinical data. These embeddings are then integrated through low-rank bilinear cross-modal fusion~\cite{liu2018efficient} to model conditional interactions across modalities while controlling parameter growth. The model outputs continuous risk scores that are subsequently mapped to survival times using a nonparametric calibration procedure based on the Kaplan--Meier estimator~\cite{kaplan1958nonparametric}. By decomposing multimodal reasoning into independent pairwise interactions, the proposed fusion design promotes structural interpretability and parameter efficiency compared with full tensor and hierarchical fusion strategies. Experiments on the CHIMERA challenge dataset demonstrate improved predictive performance over concatenation-based baselines and competitive generalization on hidden evaluation cohorts. These results indicate that the proposed framework is a promising approach for multimodal survival prediction in HR-NMIBC. The implementation is publicly available at https://github.com/hassancpu/ChimeraChallenge2025_Task_3.
Hassan Keshvarikhojasteh, Josien P. W. Pluim, Mitko Veta
Breast cancer is a leading cause of cancer-related mortality worldwide, and timely accurate diagnosis is critical to improving survival outcomes. While convolutional neural networks (CNNs) have demonstrated strong performance on histopathology image classification, and machine learning models on structured electronic health records (EHR) have shown utility for clinical risk stratification, most existing work treats these modalities in isolation. This paper presents a systematic multimodal framework that integrates patch-level histopathology features from the BreCaHAD dataset with structured clinical data from MIMIC-IV. We train and evaluate unimodal image models (a simple CNN baseline and ResNet-18 with transfer learning), unimodal tabular models (XGBoost and a multilayer perceptron), and an intermediate-fusion model that concatenates latent representations from both modalities. ResNet-18 achieves near-perfect accuracy (1.000) and AUC (1.000) on three-class patch-level classification, while XGBoost achieves 98% accuracy on the EHR prediction task. The intermediate fusion model yields a macro-average AUC of 0.997, outperforming all unimodal baselines and delivering the largest improvements on the diagnostically critical but class-imbalanced mitosis category (AUC 0.994). Grad-CAM and SHAP interpretability analyses validate that model decisions align with established pathological and clinical criteria. Our results demonstrate that multimodal integration delivers meaningful improvements in both predictive performance and clinical transparency.
Aditya Shribhagwan Khandelwal, Mohammad Samar Ansari, Asra Aslam
Accurate bladder tumor segmentation and assessment of mus- cle invasion from T2-weighted MRI are important for treatment plan- ning, but developing robust models across institutions is challenging be- cause patient data cannot be centrally pooled and imaging characteristics vary across scanners and acquisition protocols. We propose a federated multi-task learning framework for joint bladder tumor segmentation and MIBC/NMIBC classification across four clinical centers. The proposed Swin Hybrid model combines a ResNet-34 branch for local texture and boundary information with a Swin-Tiny Transformer for global anatomi- cal context. A segmentation-guided classification mechanism further uses tumor localization information to support MIBC prediction. We also investigate several augmentation strategies under both centralized and federated training to improve robustness to multi-center variability. Ex- periments on the FedBCa dataset show that the Swin Hybrid provides the best overall balance between segmentation and classification among the evaluated architectures. Under federated training, Geo+Elastic aug- mentation achieved a DSC of 0.8100 and a patient-level AUC of 0.8931, yielding the highest combined score of 0.8474. These results demonstrate that joint segmentation and classification can be effectively performed across multiple institutions using federated training without centralizing patient data.