Rapid Computer-Aided Diagnosis of Stroke by Serum Metabolic Fingerprint Based Multi-Modal Recognition

Stroke is a leading cause of mortality and disability worldwide, expected to result in 61 million disability-adjusted life-years in 2020. Rapid diagnostics is the core of stroke management for early prevention and medical treatment. Serum metabolic fingerprints (SMFs) reflect underlying disease progression, predictive of patient phenotypes. Deep learning (DL) encoding SMFs with clinical indexes outperforms single biomarkers, while posing challenges with poor prediction to interpret by feature selection. Herein, rapid computer-aided diagnosis of stroke is performed using SMF based multi-modal recognition by DL, to combine adaptive machine learning with a novel feature selection approach. SMFs are extracted by nano-assisted laser desorption/ionization mass spectrometry (LDI MS), consuming 100 nL of serum in seconds. A multi-modal recognition is constructed by integrating SMFs and clinical indexes with an enhanced area under curve (AUC) up to 0.845 for stroke screening, compared to single-modal diagnosis by only SMFs or clinical indexes. The prediction of DL is addressed by selecting 20 key metabolite features with differential regulation through a saliency map approach, shedding light on the molecular mechanisms in stroke. The approach highlights the emerging role of DL in precision medicine and suggests an expanding utility for computational analysis of SMFs in stroke screening.