TPNET: A Time-Sensitive Small Sample Multimodal Network for Cardiotoxicity Risk Prediction

Cancer therapy-related cardiac dysfunction (CTRCD) is a potential complication associated with cancer treatment, particularly in patients with breast cancer, requiring monitoring of cardiac health during the treatment process. Tissue Doppler imaging (TDI) is a remarkable technique that can provide a comprehensive reflection of the left ventricle's physiological status. We hypothesized that the combination of TDI features with deep learning techniques could be utilized to predict CTRCD. To evaluate the hypothesis, we developed a temporal-multimodal pattern network for efficient training (TPNET) model to predict the incidence of CTRCD over a 24-month period based on TDI, function, and clinical data from 270 patients. Our model achieved an area under curve (AUC) of 0.83 and sensitivity of 0.88, demonstrating greater robustness compared to other existing visual models. To further translate our model's findings into practical applications, we utilized the integrated gradients (IG) attribution to perform a detailed evaluation of all the features. This analysis has identified key pathogenic signs that may have remained unnoticed, providing a viable option for implementing our model in preoperative breast cancer patients. Additionally, our findings demonstrate the potential of TPNET in discovering new causative agents for CTRCD.