name: 'radiomics-pathomics-fusion-agent'
description: 'AI-powered multimodal fusion of radiology (CT/MRI/PET) and pathology (H&E/IHC) imaging with clinical and genomic data for comprehensive cancer diagnostics and treatment prediction.'
measurable_outcome: Execute skill workflow successfully with valid output within 15 minutes.
allowed-tools:
- read_file
- run_shell_command
Radiomics Pathomics Fusion Agent
The Radiomics Pathomics Fusion Agent integrates multimodal medical imaging data from radiology (CT, MRI, PET) and digital pathology (H&E, IHC whole slide images) with clinical and genomic data using deep learning fusion architectures. It enables comprehensive cancer phenotyping, treatment response prediction, and prognostic modeling.
When to Use This Skill
- When predicting treatment response using multimodal imaging.
- For comprehensive tumor phenotyping combining macro and micro views.
- To identify imaging biomarkers correlated with genomic features.
- When building prognostic models from combined radiology-pathology.
- For AI-powered second opinion integrating all imaging modalities.
Core Capabilities
Cross-Modal Fusion: Integrate radiology and pathology features using attention.
Radiomics Extraction: Compute 3D texture, shape, intensity features from CT/MRI.
Pathomics Extraction: Extract histopathological features from WSI.
Clinical Integration: Combine imaging with clinical variables and genomics.
Treatment Response Prediction: Predict chemotherapy, immunotherapy response.
Survival Prediction: Multi-modal prognostic modeling.
Supported Imaging Modalities
| Modality |
Features Extracted |
Resolution |
| CT |
Texture, shape, density |
Volumetric 3D |
| MRI |
Multi-sequence, perfusion |
Volumetric 3D |
| PET |
SUV, metabolic features |
Volumetric 3D |
| H&E WSI |
Nuclear, tissue architecture |
40x magnification |
| IHC WSI |
Marker quantification |
20-40x |
| Multiplexed IF |
Spatial protein patterns |
Subcellular |
Fusion Architectures
| Architecture |
Method |
Strengths |
| Early Fusion |
Concatenate features |
Simple, baseline |
| Late Fusion |
Combine predictions |
Modular |
| Attention Fusion |
Cross-modal attention |
Interpretable |
| Multimodal Transformer |
Self-attention across modalities |
State-of-art |
| Graph Fusion |
GNN for relationships |
Spatial awareness |
Workflow
Input: CT/MRI DICOM, pathology WSI, clinical data, optional genomics.
Segmentation: Tumor ROI extraction from radiology.
Radiomics: Extract 3D radiomic features.
Pathomics: Extract histopathology features via foundation models.
Fusion: Multimodal feature integration.
Prediction: Treatment response, survival, biomarker prediction.
Output: Integrated predictions, attention maps, explanations.
Example Usage
User: "Predict immunotherapy response for this lung cancer patient using their CT scan and biopsy pathology."
Agent Action:
python3 Skills/Oncology/Radiomics_Pathomics_Fusion_Agent/fusion_predict.py \
--ct_dicom ct_scan/ \
--wsi_path biopsy.svs \
--clinical_data patient_clinical.json \
--genomic_data tumor_wes.vcf \
--task immunotherapy_response \
--cancer_type nsclc \
--fusion_method attention \
--output fusion_prediction/
Radiomic Feature Categories
| Category |
Features |
Count |
| Shape |
Volume, surface area, sphericity |
14 |
| First-Order |
Mean, variance, skewness, entropy |
18 |
| GLCM |
Contrast, correlation, homogeneity |
24 |
| GLRLM |
Run length, gray level emphasis |
16 |
| GLSZM |
Zone size, gray level variance |
16 |
| GLDM |
Dependence features |
14 |
| NGTDM |
Texture features |
5 |
| Total |
|
~107 |
Pathomics Feature Categories
| Category |
Source |
Features |
| Nuclear |
Segmentation |
Size, shape, texture |
| Cellular |
Detection |
Density, clustering |
| Tissue |
Architecture |
Glandular, stromal ratios |
| Foundation Model |
CONCH, TITAN, UNI |
Deep embeddings |
| Spatial |
Graph analysis |
Neighborhood patterns |
Output Components
| Output |
Description |
Format |
| Prediction |
Response/outcome probability |
.json |
| Confidence |
Prediction uncertainty |
.json |
| Attention Maps |
Cross-modal importance |
.npy, .png |
| Feature Importance |
Shapley values |
.csv |
| ROI Highlights |
Predictive regions |
DICOM-SEG, GeoJSON |
| Report |
Clinical summary |
.pdf |
Clinical Applications
| Application |
Modalities Used |
Performance |
| NSCLC Immunotherapy |
CT + H&E |
AUC 0.82-0.88 |
| HCC Survival |
MRI + H&E |
C-index 0.78 |
| Breast Neoadjuvant |
MRI + H&E |
AUC 0.85 |
| HNSCC HPV/Response |
CT + H&E |
AUC 0.89 |
| CRC MSI Prediction |
CT + H&E |
AUC 0.86 |
AI/ML Components
Radiomics Pipeline:
- PyRadiomics for feature extraction
- 3D-CNN for learned features
- Transformer for volumetric analysis
Pathomics Pipeline:
- Foundation models (CONCH, UNI, TITAN)
- MIL (Multiple Instance Learning) for WSI
- Graph networks for spatial patterns
Fusion Models:
- Cross-attention transformers
- Multimodal variational autoencoders
- Contrastive learning for alignment
Prerequisites
- Python 3.10+
- PyRadiomics, SimpleITK
- OpenSlide, HistoEncoder
- PyTorch, transformers
- CONCH/TITAN model weights
- GPU with 16GB+ VRAM
Related Skills
- Pathology_AI/CONCH_Agent - Pathology foundation model
- Radiology_AI agents - Modality-specific analysis
- Pan_Cancer_MultiOmics_Agent - Genomic integration
- TMB_Estimation_Agent - Tumor mutational burden
Multimodal Integration Strategies
| Strategy |
Description |
Use Case |
| Feature-Level |
Combine extracted features |
Limited data |
| Embedding-Level |
Fuse latent representations |
Moderate data |
| Decision-Level |
Ensemble predictions |
Interpretability |
| End-to-End |
Joint training |
Large data |
Special Considerations
- Data Alignment: Ensure imaging from same timepoint
- Missing Modalities: Handle incomplete multimodal data
- Class Imbalance: Balance training across outcomes
- Interpretability: Attention maps for clinical trust
- Validation: External multi-site validation essential
Quality Control
| QC Check |
Threshold |
Action |
| CT coverage |
>90% tumor |
Rescan if needed |
| WSI quality |
Blur score <X |
Re-scan slide |
| Segmentation |
Dice >0.85 |
Manual review |
| Feature stability |
ICC >0.8 |
Robust features only |
Regulatory Considerations
| Aspect |
Status |
| FDA Clearance |
Individual modality tools cleared |
| Multimodal Fusion |
Research use only (RUO) |
| Clinical Integration |
PACS/LIS integration pathways |
| Explainability |
Required for clinical adoption |
Author
AI Group - Biomedical AI Platform
1---2name: radiomics-pathomics-fusion-agent3description: <!--4---5<!--6# COPYRIGHT NOTICE7# This file is part of the "Universal Biomedical Skills" project.8# Copyright (c) 2026 MD BABU MIA, PhD <md.babu.mia@mssm.edu>9# All Rights Reserved.10#11# This code is proprietary and confidential.12# Unauthorized copying of this file, via any medium is strictly prohibited.13#14# Provenance: Authenticated by MD BABU MIA1516-->1718---19name: 'radiomics-pathomics-fusion-agent'20description: 'AI-powered multimodal fusion of radiology (CT/MRI/PET) and pathology (H&E/IHC) imaging with clinical and genomic data for comprehensive cancer diagnostics and treatment prediction.'21measurable_outcome: Execute skill workflow successfully with valid output within 15 minutes.22allowed-tools:23 - read_file24 - run_shell_command25---262728# Radiomics Pathomics Fusion Agent2930The **Radiomics Pathomics Fusion Agent** integrates multimodal medical imaging data from radiology (CT, MRI, PET) and digital pathology (H&E, IHC whole slide images) with clinical and genomic data using deep learning fusion architectures. It enables comprehensive cancer phenotyping, treatment response prediction, and prognostic modeling.3132## When to Use This Skill3334* When predicting treatment response using multimodal imaging.35* For comprehensive tumor phenotyping combining macro and micro views.36* To identify imaging biomarkers correlated with genomic features.37* When building prognostic models from combined radiology-pathology.38* For AI-powered second opinion integrating all imaging modalities.3940## Core Capabilities41421. **Cross-Modal Fusion**: Integrate radiology and pathology features using attention.43442. **Radiomics Extraction**: Compute 3D texture, shape, intensity features from CT/MRI.45463. **Pathomics Extraction**: Extract histopathological features from WSI.47484. **Clinical Integration**: Combine imaging with clinical variables and genomics.49505. **Treatment Response Prediction**: Predict chemotherapy, immunotherapy response.51526. **Survival Prediction**: Multi-modal prognostic modeling.5354## Supported Imaging Modalities5556| Modality | Features Extracted | Resolution |57|----------|-------------------|------------|58| CT | Texture, shape, density | Volumetric 3D |59| MRI | Multi-sequence, perfusion | Volumetric 3D |60| PET | SUV, metabolic features | Volumetric 3D |61| H&E WSI | Nuclear, tissue architecture | 40x magnification |62| IHC WSI | Marker quantification | 20-40x |63| Multiplexed IF | Spatial protein patterns | Subcellular |6465## Fusion Architectures6667| Architecture | Method | Strengths |68|--------------|--------|-----------|69| Early Fusion | Concatenate features | Simple, baseline |70| Late Fusion | Combine predictions | Modular |71| Attention Fusion | Cross-modal attention | Interpretable |72| Multimodal Transformer | Self-attention across modalities | State-of-art |73| Graph Fusion | GNN for relationships | Spatial awareness |7475## Workflow76771. **Input**: CT/MRI DICOM, pathology WSI, clinical data, optional genomics.78792. **Segmentation**: Tumor ROI extraction from radiology.80813. **Radiomics**: Extract 3D radiomic features.82834. **Pathomics**: Extract histopathology features via foundation models.84855. **Fusion**: Multimodal feature integration.86876. **Prediction**: Treatment response, survival, biomarker prediction.88897. **Output**: Integrated predictions, attention maps, explanations.9091## Example Usage9293**User**: "Predict immunotherapy response for this lung cancer patient using their CT scan and biopsy pathology."9495**Agent Action**:96```bash97python3 Skills/Oncology/Radiomics_Pathomics_Fusion_Agent/fusion_predict.py \98 --ct_dicom ct_scan/ \99 --wsi_path biopsy.svs \100 --clinical_data patient_clinical.json \101 --genomic_data tumor_wes.vcf \102 --task immunotherapy_response \103 --cancer_type nsclc \104 --fusion_method attention \105 --output fusion_prediction/106```107108## Radiomic Feature Categories109110| Category | Features | Count |111|----------|----------|-------|112| Shape | Volume, surface area, sphericity | 14 |113| First-Order | Mean, variance, skewness, entropy | 18 |114| GLCM | Contrast, correlation, homogeneity | 24 |115| GLRLM | Run length, gray level emphasis | 16 |116| GLSZM | Zone size, gray level variance | 16 |117| GLDM | Dependence features | 14 |118| NGTDM | Texture features | 5 |119| **Total** | | **~107** |120121## Pathomics Feature Categories122123| Category | Source | Features |124|----------|--------|----------|125| Nuclear | Segmentation | Size, shape, texture |126| Cellular | Detection | Density, clustering |127| Tissue | Architecture | Glandular, stromal ratios |128| Foundation Model | CONCH, TITAN, UNI | Deep embeddings |129| Spatial | Graph analysis | Neighborhood patterns |130131## Output Components132133| Output | Description | Format |134|--------|-------------|--------|135| Prediction | Response/outcome probability | .json |136| Confidence | Prediction uncertainty | .json |137| Attention Maps | Cross-modal importance | .npy, .png |138| Feature Importance | Shapley values | .csv |139| ROI Highlights | Predictive regions | DICOM-SEG, GeoJSON |140| Report | Clinical summary | .pdf |141142## Clinical Applications143144| Application | Modalities Used | Performance |145|-------------|-----------------|-------------|146| NSCLC Immunotherapy | CT + H&E | AUC 0.82-0.88 |147| HCC Survival | MRI + H&E | C-index 0.78 |148| Breast Neoadjuvant | MRI + H&E | AUC 0.85 |149| HNSCC HPV/Response | CT + H&E | AUC 0.89 |150| CRC MSI Prediction | CT + H&E | AUC 0.86 |151152## AI/ML Components153154**Radiomics Pipeline**:155- PyRadiomics for feature extraction156- 3D-CNN for learned features157- Transformer for volumetric analysis158159**Pathomics Pipeline**:160- Foundation models (CONCH, UNI, TITAN)161- MIL (Multiple Instance Learning) for WSI162- Graph networks for spatial patterns163164**Fusion Models**:165- Cross-attention transformers166- Multimodal variational autoencoders167- Contrastive learning for alignment168169## Prerequisites170171* Python 3.10+172* PyRadiomics, SimpleITK173* OpenSlide, HistoEncoder174* PyTorch, transformers175* CONCH/TITAN model weights176* GPU with 16GB+ VRAM177178## Related Skills179180* Pathology_AI/CONCH_Agent - Pathology foundation model181* Radiology_AI agents - Modality-specific analysis182* Pan_Cancer_MultiOmics_Agent - Genomic integration183* TMB_Estimation_Agent - Tumor mutational burden184185## Multimodal Integration Strategies186187| Strategy | Description | Use Case |188|----------|-------------|----------|189| Feature-Level | Combine extracted features | Limited data |190| Embedding-Level | Fuse latent representations | Moderate data |191| Decision-Level | Ensemble predictions | Interpretability |192| End-to-End | Joint training | Large data |193194## Special Considerations1951961. **Data Alignment**: Ensure imaging from same timepoint1972. **Missing Modalities**: Handle incomplete multimodal data1983. **Class Imbalance**: Balance training across outcomes1994. **Interpretability**: Attention maps for clinical trust2005. **Validation**: External multi-site validation essential201202## Quality Control203204| QC Check | Threshold | Action |205|----------|-----------|--------|206| CT coverage | >90% tumor | Rescan if needed |207| WSI quality | Blur score <X | Re-scan slide |208| Segmentation | Dice >0.85 | Manual review |209| Feature stability | ICC >0.8 | Robust features only |210211## Regulatory Considerations212213| Aspect | Status |214|--------|--------|215| FDA Clearance | Individual modality tools cleared |216| Multimodal Fusion | Research use only (RUO) |217| Clinical Integration | PACS/LIS integration pathways |218| Explainability | Required for clinical adoption |219220## Author221222AI Group - Biomedical AI Platform223224225<!-- AUTHOR_SIGNATURE: 9a7f3c2e-MD-BABU-MIA-2026-MSSM-SECURE -->