Multi-Modal Oral Cancer Detection Using Weighted Ensemble Convolutional Neural Networks

Abstract: Aims Late diagnosis of Oral Squamous Cell Carcinoma (OSCC) contributes significantly to its high global mortality rate, with over 50\% of cases detected at advanced stages and a 5-year survival rate below 50\% according to WHO statistics. This study aims to improve early detection of OSCC by developing a multimodal deep learning framework that integrates clinical, radiological, and histopathological images using a weighted ensemble of DenseNet-121 convolutional neural networks (CNNs). Material and Methods A retrospective study was conducted using publicly available datasets representing three distinct medical imaging modalities. Each modality-specific dataset was used to train a DenseNet-121 CNN via transfer learning. Augmentation and modality-specific preprocessing were applied to increase robustness. Predictions were fused using a validation-weighted ensemble strategy. Evaluation was performed using accuracy, precision, recall, F1-score. Results High validation accuracy was achieved for radiological (100\%) and histopathological (95.12\%) modalities, with clinical images performing lower (63.10\%) due to visual heterogeneity. The ensemble model demonstrated improved diagnostic robustness with an overall accuracy of 84.58\% on a multimodal validation dataset of 55 samples. Conclusion The multimodal ensemble framework bridges gaps in the current diagnostic workflow by offering a non-invasive, AI-assisted triage tool that enhances early identification of high-risk lesions. It supports clinicians in decision-making, aligning with global oncology guidelines to reduce diagnostic delays and improve patient outcomes.