Department of Pathology, Chinese PLA General Hospital, 100853, Beijing, China.
Thorough Images, 100176, Beijing, China.
Mod Pathol. 2022 Sep;35(9):1262-1268. doi: 10.1038/s41379-022-01073-z. Epub 2022 Apr 8.
Previous studies on deep learning (DL) applications in pathology have focused on pathologist-versus-algorithm comparisons. However, DL will not replace the breadth and contextual knowledge of pathologists; rather, only through their combination may the benefits of DL be achieved. A fully crossed multireader multicase study was conducted to evaluate DL assistance with pathologists' diagnosis of gastric cancer. A total of 110 whole-slide images (WSI) (50 malignant and 60 benign) were interpreted by 16 board-certified pathologists with or without DL assistance, with a washout period between sessions. DL-assisted pathologists achieved a higher area under receiver operating characteristic curve (ROC-AUC) (0.911 vs. 0.863, P = 0.003) than unassisted in interpreting the 110 WSIs. Pathologists with DL assistance demonstrated higher sensitivity in detection of gastric cancer than without (90.63% vs. 82.75%, P = 0.010). No significant difference was observed in specificity with or without deep learning assistance (78.23% vs. 79.90%, P = 0.468). The average review time per WSI was shortened with DL assistance than without (22.68 vs. 26.37 second, P = 0.033). Our results demonstrated that DL assistance indeed improved pathologists' accuracy and efficiency in gastric cancer diagnosis and further boosted the acceptance of this new technique.
先前关于深度学习（DL）在病理学中应用的研究主要集中在病理学家与算法之间的比较。然而，DL 不会取代病理学家的广度和背景知识；相反，只有通过结合两者，才能实现 DL 的优势。我们进行了一项完全交叉的多读者多病例研究，以评估 DL 对病理学家胃癌诊断的辅助作用。共 110 张全切片图像（WSI）（50 张恶性和 60 张良性）由 16 名具有董事会认证的病理学家进行解读，两次解读之间有洗脱期。在解释这 110 张 WSI 时，DL 辅助的病理学家比未辅助的病理学家获得了更高的受试者工作特征曲线（ROC-AUC）下面积（0.911 比 0.863，P=0.003）。有 DL 辅助的病理学家在检测胃癌方面的敏感性高于无辅助的（90.63%比 82.75%，P=0.010）。有或没有深度学习辅助时，特异性没有显著差异（78.23%比 79.90%，P=0.468）。有 DL 辅助时每张 WSI 的平均审阅时间短于无辅助时（22.68 比 26.37 秒，P=0.033）。我们的研究结果表明，DL 辅助确实提高了病理学家在胃癌诊断中的准确性和效率，并进一步提高了对这项新技术的接受度。
