Niazi M Khalid Khan, Zynger Debra L, Clinton Steven K, Chen James, Koyuturk Mehmet, LaFramboise Thomas, Gurcan Metin
IEEE J Biomed Health Inform. 2017 Jul;21(4):1027-1038. doi: 10.1109/JBHI.2016.2565515. Epub 2016 May 10.
Histopathologic features, particularly Gleason grading system, have contributed significantly to the diagnosis, treatment, and prognosis of prostate cancer for decades. However, prostate cancer demonstrates enormous heterogeneity in biological behavior, thus establishing improved prognostic and predictive markers is particularly important to personalize therapy of men with clinically localized and newly diagnosed malignancy. Many automated grading systems have been developed for Gleason grading but acceptance in the medical community has been lacking due to poor interpretability. To overcome this problem, we developed a set of visually meaningful features to differentiate between low- and high-grade prostate cancer. The visually meaningful feature set consists of luminal and architectural features. For luminal features, we compute: 1) the shortest path from the nuclei to their closest luminal spaces; 2) ratio of the epithelial nuclei to the total number of nuclei. A nucleus is considered an epithelial nucleus if the shortest path between it and the luminal space does not contain any other nucleus; 3) average shortest distance of all nuclei to their closest luminal spaces. For architectural features, we compute directional changes in stroma and nuclei using directional filter banks. These features are utilized to create two subspaces; one for prostate images histopathologically assessed as low grade and the other for high grade. The grade associated with a subspace, which results in the minimum reconstruction error is considered as the prediction for the test image. For training, we utilized 43 regions of interest (ROI) images, which were extracted from 25 prostate whole slide images of The Cancer Genome Atlas (TCGA) database. For testing, we utilized an independent dataset of 88 ROIs extracted from 30 prostate whole slide images. The method resulted in 93.0% and 97.6% training and testing accuracies, respectively, for the spectrum of cases considered. The application of visually meaningful features provided promising levels of accuracy and consistency for grading prostate cancer.
几十年来,组织病理学特征,尤其是 Gleason 分级系统,对前列腺癌的诊断、治疗和预后起到了重要作用。然而,前列腺癌在生物学行为上表现出极大的异质性,因此建立更好的预后和预测标志物对于为临床局限性和新诊断的恶性肿瘤患者进行个性化治疗尤为重要。已经开发了许多用于 Gleason 分级的自动分级系统,但由于可解释性差,尚未被医学界所接受。为了克服这个问题,我们开发了一组具有视觉意义的特征来区分低级别和高级别前列腺癌。具有视觉意义的特征集包括管腔特征和结构特征。对于管腔特征,我们计算:1)细胞核到其最接近的管腔空间的最短路径;2)上皮细胞核与细胞核总数的比率。如果一个细胞核与管腔空间之间的最短路径不包含任何其他细胞核,则该细胞核被视为上皮细胞核;3)所有细胞核到其最接近的管腔空间的平均最短距离。对于结构特征,我们使用方向滤波器组计算基质和细胞核的方向变化。这些特征被用于创建两个子空间;一个用于组织病理学评估为低级别前列腺图像,另一个用于高级别。与子空间相关联的级别,即导致最小重建误差的级别,被视为对测试图像的预测。在训练时,我们使用了 43 个感兴趣区域(ROI)图像,这些图像是从癌症基因组图谱(TCGA)数据库的 25 张前列腺全切片图像中提取的。在测试时,我们使用了从 30 张前列腺全切片图像中提取的 88 个 ROI 的独立数据集。对于所考虑的病例范围,该方法的训练和测试准确率分别为 93.0%和 97.6%。具有视觉意义的特征的应用为前列腺癌分级提供了有前景的准确性和一致性水平。