Evidence map›Paper›PMID 41022881›Full record

ArticleNature communications2025

Uncertainty-aware ensemble of foundation models differentiates glioblastoma from its mimics.

Junhan Zhao, Shih-Yen Lin, Raphaël Attias, Liza Mathews, Christian Engel, Guillaume Larghero, Dmytro Vremenko, Ting-Wan Kao, Tsung-Hua Lee, Yu-Hsuan Wang and 17 more

Abstract read
In one paragraph

Article in Nature communications, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Review
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

27 authors.

Junhan Zhao *Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA.ORCID http://orcid.org/0000-0002-0316-8365
Shih-Yen Lin *Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA.
Raphaël AttiasDepartment of Biomedical Informatics, Harvard Medical School, Boston, MA, USA.ORCID http://orcid.org/0009-0005-8413-7358
Liza MathewsDepartment of Biomedical Informatics, Harvard Medical School, Boston, MA, USA.
Christian EngelDepartment of Biomedical Informatics, Harvard Medical School, Boston, MA, USA.
Guillaume LargheroDepartment of Biomedical Informatics, Harvard Medical School, Boston, MA, USA.
Dmytro VremenkoDepartment of Biomedical Informatics, Harvard Medical School, Boston, MA, USA.
Ting-Wan KaoDepartment of Biomedical Informatics, Harvard Medical School, Boston, MA, USA.
Tsung-Hua LeeDepartment of Biomedical Informatics, Harvard Medical School, Boston, MA, USA.
Yu-Hsuan WangDepartment of Computer Science and Information Engineering, National Cheng Kung University, Tainan, Taiwan.
Cheng Che TsaiDepartment of Biomedical Informatics, Harvard Medical School, Boston, MA, USA.
Eliana MarosticaDepartment of Biomedical Informatics, Harvard Medical School, Boston, MA, USA.ORCID http://orcid.org/0000-0002-2061-243X
Ying-Chun LoDepartment of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.ORCID http://orcid.org/0000-0002-8893-0645
David MeredithDepartment of Pathology, Brigham and Women's Hospital, Boston, MA, USA.
Keith L LigonDepartment of Pathology, Dana-Farber Cancer Institute, Boston, MA, USA.ORCID http://orcid.org/0000-0002-7733-600X
Omar ArnaoutDepartment of Neurosurgery, Brigham and Women's Hospital, Boston, MA, USA.
Thomas Roetzer-PejrimovskyDivision of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria.ORCID http://orcid.org/0000-0001-8875-7304
Shih-Chieh LinDivision of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan.
Natalie Nc ShihDepartment of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Nipon ChaisuriyaDepartment of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.ORCID http://orcid.org/0000-0003-1241-8503
David J CookDepartment of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.ORCID http://orcid.org/0009-0007-6196-4179
Jung-Hsien ChiangDepartment of Computer Science and Information Engineering, National Cheng Kung University, Tainan, Taiwan.ORCID http://orcid.org/0000-0002-4657-6705
Chia-Jen LiuDepartment of Biomedical Informatics, Harvard Medical School, Boston, MA, USA.ORCID http://orcid.org/0000-0001-7945-9292
Adelheid WoehrerDivision of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria.ORCID http://orcid.org/0000-0001-8435-8189
Jeffrey A GoldenDepartment of Pathology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
MacLean P NasrallahDepartment of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.ORCID http://orcid.org/0000-0003-4861-0898
Kun-Hsing YuDepartment of Biomedical Informatics, Harvard Medical School, Boston, MA, USA. Kun-Hsing_Yu@hms.harvard.edu.ORCID http://orcid.org/0000-0001-9892-8218

Funding

Robust, Generalizable, and Fair Machine Learning Models for BiomedicineR35GM142879 · NIGMS · HARVARD MEDICAL SCHOOL · PI YU, KUN-HSING · 2021 to 2025
$2.4M
Mitigating Hematologic Adverse Events in Patients with Myeloid Malignancies: A Novel Causal Artificial Intelligence ApproachR01HL174679 · NHLBI · HARVARD MEDICAL SCHOOL · PI Kun-Hsing Yu · 2024 to 2026
$2.3M
American Cancer Society (American Cancer Society, Inc.) RSG-24-1253761-01-ESEDGoogle Google Research Scholar AwardHarvard Medical School Dean's Innovation AwardNHLBI NIH HHS R01 HL174679NIGMS NIH HHS R35 GM142879U.S. Department of Defense (United States Department of Defense) HT9425-23-1-0523U.S. Department of Health & Human Services | NIH | National Institute of General Medical Sciences (NIGMS) R35GM142879
6 · The paper itself

Abstract

Accurate pathological diagnosis is crucial in guiding personalized treatments for patients with central nervous system cancers. Distinguishing glioblastoma and primary central nervous system lymphoma is particularly challenging due to their overlapping pathology features, despite the distinct treatments required. To address this challenge, we establish the Pathology Image Characterization Tool with Uncertainty-aware Rapid Evaluations (PICTURE) system using 2141 pathology slides collected worldwide. PICTURE employs Bayesian inference, deep ensemble, and normalizing flow to account for the uncertainties in its predictions and training set labels. PICTURE accurately diagnoses glioblastoma and primary central nervous system lymphoma with an area under the receiver operating characteristic curve (AUROC) of 0.989, with the results validated in five independent cohorts (AUROC = 0.924-0.996). In addition, PICTURE identifies samples belonging to 67 types of rare central nervous system cancers that are neither gliomas nor lymphomas. Our approaches provide a generalizable framework for differentiating pathological mimics and enable rapid diagnoses for central nervous system cancer patients.

Indexed as

Brain NeoplasmsCentral Nervous System NeoplasmsGlioblastomaLymphomaBayes TheoremDiagnosis, DifferentialFemaleHumansMaleROC CurveUncertainty

Identifiers

PMID41022881
PMCPMC12480093

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.