Integrating Multi-Omics and Medical Imaging in Artificial Intelligence-Based Cancer Research: An Umbrella Review of...

Background: The combination of multi-omics data, including genomics, transcriptomics, and epigenomics, with medical imaging modalities (PET, CT, MRI, histopathology) has emerged in recent years as a promising direction for the advancement of precision oncology. Many researchers have contributed to this domain, exploring the multi-modality aspect of using both multi-omics and image data for better cancer identification, subtype classifications, cancer prognosis, etc. Methods: We present an umbrella review summarizing the state of the art in fusing imaging modalities with omics and artificial intelligence, focusing on existing reviews and meta-analyses. The analysis highlights early, late, and hybrid fusion strategies and their advantages and disadvantages, mainly in tumor classification, prognosis, and treatment prediction. We searched review articles until 25 May 2025 across multiple databases following PRISMA guidelines, with registration on PROSPERO (CRD420251062147). Results: After identifying 56 articles from different databases (i.e., PubMed, Scopus, Web of Science and Dimensions.ai), 35 articles were screened out based on the inclusion and exclusion criteria, keeping 21 studies for the umbrella review. Discussion: We investigated prominent fusion techniques in various contexts of cancer types and the role of machine learning in model performance enhancement. We address the problems of model generalizability versus interpretability within the clinical context and argue how these multi-modal issues can facilitate translating research into actual clinical scenarios. Conclusions: Lastly, we recommend future work to define clearer and more reliable validation criteria, address the need for integration of human clinicians with the AI system, and describe the trust issue with AI in cancer care, which requires more standardized approaches.