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Updated: Mar 4, 2026

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Time-to-Event Pretraining for 3D Medical Imaging.

Zepeng Huo1, Jason Alan Fries1, Alejandro Lozano2

  • 1Center for Biomedical Informatics Research, Stanford University.

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|March 3, 2026
PubMed
Summary
This summary is machine-generated.

New pretraining integrates 3D imaging with electronic health records (EHRs) to predict disease risk. This approach overcomes the missing context problem, improving outcome prediction and identifying novel imaging biomarkers.

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Area of Science:

  • Artificial Intelligence
  • Medical Imaging
  • Biomedical Informatics

Background:

  • Medical foundation models and imaging data are growing.
  • Current self-supervised methods for 3D imaging models capture local features but miss temporal context for long-term outcome prediction.
  • A missing context problem limits linking imaging biomarkers to disease progression.

Purpose of the Study:

  • To introduce time-to-event pretraining for 3D medical imaging models.
  • To leverage longitudinal electronic health records (EHRs) for temporal supervision.
  • To identify imaging biomarkers predictive of future disease risk.

Main Methods:

  • Developed a pretraining framework using paired, longitudinal EHR data with 18,945 CT scans.
  • Utilized time-to-event distributions across thousands of EHR-derived tasks for supervision.
  • Evaluated performance on 8 benchmark outcome prediction tasks.

Main Results:

  • Achieved an average AUROC increase of 23.7% in outcome prediction.
  • Demonstrated a 29.4% gain in Harrell's C-index across benchmark tasks.
  • Maintained diagnostic classification performance.

Conclusions:

  • Time-to-event pretraining effectively integrates longitudinal EHR and 3D imaging data.
  • The method enhances clinical risk prediction by identifying imaging biomarkers linked to long-term health outcomes.
  • This approach advances the development of medical foundation models for disease risk assessment.