# Uncovering Neuroimaging Biomarkers of Brain Tumor Surgery with AI-Driven Methods

arXiv: https://arxiv.org/abs/2507.04881 · HTML: https://mlsanity.com/paper/2507.04881/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 16 of its 44 references that are in the map.
- First posted on arXiv 7 Jul 2025.

## Builds on (most cited first, 16 of 16)

- [Grad-CAM: Visual Explanations from Deep Networks via Gradient-based Localization](https://mlsanity.com/paper/1610.02391/) (2016)
- [A Unified Approach to Interpreting Model Predictions](https://mlsanity.com/paper/1705.07874/) (2017)
- [Axiomatic Attribution for Deep Networks](https://mlsanity.com/paper/1703.01365/) (2017)
- [UMAP: Uniform Manifold Approximation and Projection for Dimension Reduction](https://mlsanity.com/paper/1802.03426/) (2018)
- [Striving for Simplicity: The All Convolutional Net](https://mlsanity.com/paper/1412.6806/) (2014)
- [Swin UNETR: Swin Transformers for Semantic Segmentation of Brain Tumors in MRI Images](https://mlsanity.com/paper/2201.01266/) (2022)
- [On the (In)fidelity and Sensitivity for Explanations](https://mlsanity.com/paper/1901.09392/) (2019)
- [Evaluating and Aggregating Feature-based Model Explanations](https://mlsanity.com/paper/2005.00631/) (2020)
- [Quantus: An Explainable AI Toolkit for Responsible Evaluation of Neural Network Explanations and Beyond](https://mlsanity.com/paper/2202.06861/) (2022)
- [Automated brain extraction of multi-sequence MRI using artificial neural networks](https://mlsanity.com/paper/1901.11341/) (2019)
- [Explainable Artificial Intelligence (XAI) 2.0: A Manifesto of Open Challenges and Interdisciplinary Research Directions](https://mlsanity.com/paper/2310.19775/) (2023)
- [The 2024 Brain Tumor Segmentation (BraTS) Challenge: Glioma Segmentation on Post-treatment MRI](https://mlsanity.com/paper/2405.18368/) (2024)
- [Latent Correlation Representation Learning for Brain Tumor Segmentation with Missing MRI Modalities](https://mlsanity.com/paper/2104.06231/) (2021)
- [A Deep Learning Approach for Brain Tumor Classification and Segmentation Using a Multiscale Convolutional Neural Network](https://mlsanity.com/paper/2402.05975/) (2024)
- [Deep learning automates bidimensional and volumetric tumor burden measurement from MRI in pre- and post-operative glioblastoma patients](https://mlsanity.com/paper/2209.01402/) (2022)
- [Solving the enigma: Enhancing faithfulness and comprehensibility in explanations of deep networks](https://mlsanity.com/paper/2405.10008/) (2024)

## Abstract (arXiv)

Brain tumor resection is a highly complex procedure with profound implications for survival and quality of life. Predicting patient outcomes is crucial to guide clinicians in balancing oncological control with preservation of neurological function. However, building reliable prediction models is severely limited by the rarity of curated datasets that include both pre- and post-surgery imaging, given the clinical, logistical and ethical challenges of collecting such data. In this study, we develop a novel framework that integrates explainable artificial intelligence (XAI) with neuroimaging-based feature engineering for survival assessment in brain tumor patients. We curated structural MRI data from 49 patients scanned pre- and post-surgery, providing a rare resource for identifying survival-related biomarkers. A key methodological contribution is the development of a global explanation optimizer, which refines survival-related feature attribution in deep learning models, thereby improving both the interpretability and reliability of predictions. From a clinical perspective, our findings provide important evidence that survival after oncological surgery is influenced by alterations in regions related to cognitive and sensory functions. These results highlight the importance of preserving areas involved in decision-making and emotional regulation to improve long-term outcomes. From a technical perspective, the proposed optimizer advances beyond state-of-the-art XAI methods by enhancing both the fidelity and comprehensibility of model explanations, thus reinforcing trust in the recognition patterns driving survival prediction. This work demonstrates the utility of XAI-driven neuroimaging analysis in identifying survival-related variability and underscores its potential to inform precision medicine strategies in brain tumor treatment.