IEEE J Biomed Health Inform. 2024 Sep;28(9):5562-5572. doi: 10.1109/JBHI.2024.3407878. Epub 2024 Sep 5.
Determining lymphoma subtypes is a crucial step for better patient treatment targeting to potentially increase their survival chances. In this context, the existing gold standard diagnosis method, which relies on gene expression technology, is highly expensive and time-consuming, making it less accessibility. Although alternative diagnosis methods based on IHC (immunohistochemistry) technologies exist (recommended by the WHO), they still suffer from similar limitations and are less accurate. Whole Slide Image (WSI) analysis using deep learning models has shown promising potential for cancer diagnosis, that could offer cost-effective and faster alternatives to existing methods. In this work, we propose a vision transformer-based framework for distinguishing DLBCL (Diffuse Large B-Cell Lymphoma) cancer subtypes from high-resolution WSIs. To this end, we introduce a multi-modal architecture to train a classifier model from various WSI modalities. We then leverage this model through a knowledge distillation process to efficiently guide the learning of a mono-modal classifier. Our experimental study conducted on a lymphoma dataset of 157 patients shows the promising performance of our mono-modal classification model, outperforming six recent state-of-the-art methods. In addition, the power-law curve, estimated on our experimental data, suggests that with more training data from a reasonable number of additional patients, our model could achieve competitive diagnosis accuracy with IHC technologies. Furthermore, the efficiency of our framework is confirmed through an additional experimental study on an external breast cancer dataset (BCI dataset).
确定淋巴瘤亚型对于更好地针对患者进行治疗以提高其生存机会至关重要。在这种情况下,现有的金标准诊断方法依赖于基因表达技术,不仅费用高昂且耗时,还难以普及。虽然存在基于免疫组织化学(IHC)技术的替代诊断方法(世界卫生组织推荐),但它们仍然存在类似的局限性,且准确性较低。基于深度学习模型的全切片图像(WSI)分析已显示出在癌症诊断方面具有巨大的潜力,它可能为现有方法提供具有成本效益且更快的替代方案。在这项工作中,我们提出了一种基于视觉转换器的框架,用于从高分辨率 WSI 中区分弥漫性大 B 细胞淋巴瘤(DLBCL)亚型。为此,我们引入了一种多模态架构,从各种 WSI 模态中训练分类器模型。然后,我们通过知识蒸馏过程利用该模型,有效地指导单模态分类器的学习。我们在一个包含 157 名患者的淋巴瘤数据集上进行的实验研究表明,我们的单模态分类模型具有出色的性能,优于六种最新的最先进方法。此外,根据我们的实验数据估计的幂律曲线表明,通过从合理数量的额外患者中获得更多的训练数据,我们的模型可以实现与 IHC 技术相当的诊断准确性。此外,我们在一个外部乳腺癌数据集(BCI 数据集)上进行的额外实验研究证实了我们框架的效率。