{
  "abstract": "Background: Estimating tumor fraction from whole-genome cell-free DNA sequencing is critical for liquid biopsy, but is hampered by weak signals and baseline noise at low tumor fractions. Existing computational methods often require matched controls or large labeled datasets for training and lack uncertainty quantification. To address these gaps, we developed purNPE, a Bayesian deep-learning framework trained without labeled cancer cell-free DNA samples. Specifically, purNPE leverages a two-part generative model: one component simulates diverse tumor copy-number profiles based on evolutionary genealogies, while a second, data-driven component learns and replicates realistic sequencing background patterns from cancer-free cell-free DNA. By training a Neural Posterior Estimator on synthetic tumor profiles augmented with learned noise, purNPE performs amortized inference in milliseconds without needing a reference sample set at inference.\n\nResults: In a real-world pan-cancer cohort, purNPE achieved comparable performance with existing methods against an orthogonal mutant-allele-fraction proxy (MAE = 0.066). In semi-synthetic and in silico experiments, purNPE showed calibrated uncertainty estimates and a dose-response across low tumor-fraction spike-ins, with separation of approximately 1% TF spike-ins from blanks under the evaluated conditions.\n\nConclusions: This work provides a proof-of-concept framework for using simulation-based inference to derive calibrated, uncertainty-aware TF estimates. Larger prospective cohorts with stronger orthogonal ground truth are required before analytical sensitivity or clinical utility can be established.\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s13040-026-00595-5.",
  "abstract_shown": true,
  "affiliations": [
    "Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, 39040 Israel",
    "Edmond J. Safra Center for Bioinformatics, Tel Aviv University, Tel Aviv, 39040 Israel",
    "Department of Oncology, Chaim Sheba Medical Center, Ramat Gan, 52621 Israel",
    "Department of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, 39040 Israel",
    "Department of Statistics and Operations Research, Tel Aviv University, Tel Aviv, 39040 Israel"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Hadas Volkov",
      "orcid": "0009-0000-1749-405X"
    },
    {
      "affs": [
        2
      ],
      "name": "Maria Raitses-Gurevich"
    },
    {
      "affs": [
        0
      ],
      "name": "Meitar Grad"
    },
    {
      "affs": [
        0
      ],
      "name": "Rani Shlayem"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Artem Danilevsky"
    },
    {
      "affs": [
        0,
        3
      ],
      "name": "Tami Rubinek"
    },
    {
      "affs": [
        4
      ],
      "name": "Malka Gorfine"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Noam Shomron"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6py4vknh2cxz4.bib",
  "cited_by": 0,
  "doi": "10.1186/s13040-026-00595-5",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13737949/",
  "id": "6py4vknh2cxz4",
  "issns": [
    "1756-0381"
  ],
  "landing_url": "https://doi.org/10.1186/s13040-026-00595-5",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Methodology"
    ],
    [
      "openalex",
      "1306|Cancer Genomics and Diagnostics"
    ]
  ],
  "openalex": "W7196972844",
  "pdf_url": null,
  "pmcid": "PMC13737949",
  "pmid": "42983847",
  "published": "2026-08-06",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/6py4vknh2cxz4.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T12:23:02Z",
      "native_id": "PMC13737949",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s13040-026-00595-5"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:1306|Cancer Genomics and Diagnostics",
      "subfield": "oncology"
    }
  ],
  "title": "Simulation-based Bayesian deep learning enables uncertainty-aware tumor fraction estimation in cell-free DNA",
  "title_text": "Simulation-based Bayesian deep learning enables uncertainty-aware tumor fraction estimation in cell-free DNA",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:23:02Z",
  "url": "https://research.draconitic.com/paper/6py4vknh2cxz4",
  "venue": "BioData Mining",
  "versions": []
}