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基于两步深度学习方法从全切片病理图像检测肺癌淋巴结转移。

Detection of Lung Cancer Lymph Node Metastases from Whole-Slide Histopathologic Images Using a Two-Step Deep Learning Approach.

机构信息

Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto, Nagasaki, Japan.

Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto, Nagasaki, Japan; Department of Pathology, Kameda Medical Center, Kamogawa, Chiba, Japan.

出版信息

Am J Pathol. 2019 Dec;189(12):2428-2439. doi: 10.1016/j.ajpath.2019.08.014. Epub 2019 Sep 18.

Abstract

The application of deep learning for the detection of lymph node metastases on histologic slides has attracted worldwide attention due to its potentially important role in patient treatment and prognosis. Despite this attention, false-positive predictions remain problematic, particularly in the case of reactive lymphoid follicles. In this study, a novel two-step deep learning algorithm was developed to address the issue of false-positive prediction while maintaining accurate cancer detection. Three-hundred and forty-nine whole-slide lung cancer lymph node images, including 233 slides for algorithm training, 10 slides for validation, and 106 slides for evaluation, were collected. In the first step, a deep learning algorithm was used to eliminate frequently misclassified noncancerous regions (lymphoid follicles). In the second step, a deep learning classifier was developed to detect cancer cells. Using this two-step approach, errors were reduced by 36.4% on average and up to 89% in slides with reactive lymphoid follicles. Furthermore, 100% sensitivity was reached in cases of macrometastases, micrometastases, and isolated tumor cells. To reduce the small number of remaining false positives, a receiver-operating characteristic curve was created using foci size thresholds of 0.6 mm and 0.7 mm, achieving sensitivity and specificity of 79.6% and 96.5%, and 75.5% and 98.2%, respectively. A two-step approach can be used to detect lung cancer metastases in lymph node tissue effectively and with few false positives.

摘要

深度学习在组织切片中检测淋巴结转移的应用引起了全球关注,因为它在患者治疗和预后方面具有潜在的重要作用。尽管受到了关注,但假阳性预测仍然是一个问题,特别是在反应性淋巴滤泡的情况下。在这项研究中,开发了一种新的两步深度学习算法,以解决假阳性预测的问题,同时保持对癌症的准确检测。收集了 349 张全幻灯片肺癌淋巴结图像,包括 233 张用于算法训练的幻灯片、10 张用于验证的幻灯片和 106 张用于评估的幻灯片。在第一步中,使用深度学习算法消除经常被错误分类的非癌区域(淋巴滤泡)。在第二步中,开发了一种深度学习分类器来检测癌细胞。使用这种两步方法,错误率平均降低了 36.4%,在有反应性淋巴滤泡的幻灯片中降低了高达 89%。此外,在宏转移、微转移和孤立肿瘤细胞的情况下,达到了 100%的灵敏度。为了减少剩余假阳性的数量,使用焦点大小阈值为 0.6 毫米和 0.7 毫米创建了一个接收器工作特征曲线,分别达到了 79.6%和 96.5%的灵敏度和特异性,以及 75.5%和 98.2%的特异性。两步法可有效、低假阳性地检测淋巴结组织中的肺癌转移。

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