Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
Division of Imaging, Diagnostics, and Software Reliability, Office Science and Engineering Laboratories, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, MD, USA.
J Pathol. 2023 Dec;261(4):378-384. doi: 10.1002/path.6208. Epub 2023 Oct 4.
Quantifying tumor-infiltrating lymphocytes (TILs) in breast cancer tumors is a challenging task for pathologists. With the advent of whole slide imaging that digitizes glass slides, it is possible to apply computational models to quantify TILs for pathologists. Development of computational models requires significant time, expertise, consensus, and investment. To reduce this burden, we are preparing a dataset for developers to validate their models and a proposal to the Medical Device Development Tool (MDDT) program in the Center for Devices and Radiological Health of the U.S. Food and Drug Administration (FDA). If the FDA qualifies the dataset for its submitted context of use, model developers can use it in a regulatory submission within the qualified context of use without additional documentation. Our dataset aims at reducing the regulatory burden placed on developers of models that estimate the density of TILs and will allow head-to-head comparison of multiple computational models on the same data. In this paper, we discuss the MDDT preparation and submission process, including the feedback we received from our initial interactions with the FDA and propose how a qualified MDDT validation dataset could be a mechanism for open, fair, and consistent measures of computational model performance. Our experiences will help the community understand what the FDA considers relevant and appropriate (from the perspective of the submitter), at the early stages of the MDDT submission process, for validating stromal TIL density estimation models and other potential computational models. © 2023 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.
量化乳腺癌肿瘤中的肿瘤浸润淋巴细胞 (TILs) 对病理学家来说是一项具有挑战性的任务。随着全玻片成像技术的出现,数字化玻璃载玻片成为可能,从而可以应用计算模型来为病理学家定量 TILs。计算模型的开发需要大量的时间、专业知识、共识和投资。为了减轻这种负担,我们正在为开发人员准备一个数据集,用于验证他们的模型,并向美国食品和药物管理局 (FDA) 的设备和放射卫生中心的医疗设备开发工具 (MDDT) 计划提交提案。如果 FDA 为其提交的使用环境合格了数据集,模型开发人员可以在合格的使用环境中在监管提交中使用它,而无需额外的文件。我们的数据集旨在减轻用于估计 TIL 密度的模型的开发人员的监管负担,并允许在相同数据上对头对头比较多个计算模型。在本文中,我们讨论了 MDDT 的准备和提交过程,包括我们从与 FDA 的初步互动中收到的反馈,并提出了合格的 MDDT 验证数据集如何成为计算模型性能的开放、公平和一致度量的机制。我们的经验将帮助社区了解在 MDDT 提交过程的早期阶段,FDA 从提交者的角度认为哪些是相关和适当的,用于验证基质 TIL 密度估计模型和其他潜在的计算模型。© 2023 作者。《病理学杂志》由 John Wiley & Sons Ltd 代表大不列颠和爱尔兰病理学学会出版。本文由美国政府雇员贡献,其工作在美国属于公有领域。