Deep learning algorithms out-perform veterinary pathologists in detecting the mitotically most active tumor region.


Journal

Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288

Informations de publication

Date de publication:
05 10 2020
Historique:
received: 22 01 2020
accepted: 15 09 2020
entrez: 6 10 2020
pubmed: 7 10 2020
medline: 5 1 2021
Statut: epublish

Résumé

Manual count of mitotic figures, which is determined in the tumor region with the highest mitotic activity, is a key parameter of most tumor grading schemes. It can be, however, strongly dependent on the area selection due to uneven mitotic figure distribution in the tumor section. We aimed to assess the question, how significantly the area selection could impact the mitotic count, which has a known high inter-rater disagreement. On a data set of 32 whole slide images of H&E-stained canine cutaneous mast cell tumor, fully annotated for mitotic figures, we asked eight veterinary pathologists (five board-certified, three in training) to select a field of interest for the mitotic count. To assess the potential difference on the mitotic count, we compared the mitotic count of the selected regions to the overall distribution on the slide. Additionally, we evaluated three deep learning-based methods for the assessment of highest mitotic density: In one approach, the model would directly try to predict the mitotic count for the presented image patches as a regression task. The second method aims at deriving a segmentation mask for mitotic figures, which is then used to obtain a mitotic density. Finally, we evaluated a two-stage object-detection pipeline based on state-of-the-art architectures to identify individual mitotic figures. We found that the predictions by all models were, on average, better than those of the experts. The two-stage object detector performed best and outperformed most of the human pathologists on the majority of tumor cases. The correlation between the predicted and the ground truth mitotic count was also best for this approach (0.963-0.979). Further, we found considerable differences in position selection between pathologists, which could partially explain the high variance that has been reported for the manual mitotic count. To achieve better inter-rater agreement, we propose to use a computer-based area selection for support of the pathologist in the manual mitotic count.

Identifiants

pubmed: 33020510
doi: 10.1038/s41598-020-73246-2
pii: 10.1038/s41598-020-73246-2
pmc: PMC7536430
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

16447

Références

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Auteurs

Marc Aubreville (M)

Pattern Recognition Lab, Computer Science, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany. marc.aubreville@fau.de.

Christof A Bertram (CA)

Institute of Veterinary Pathology, Freie Universität Berlin, Berlin, Germany.

Christian Marzahl (C)

Pattern Recognition Lab, Computer Science, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.

Corinne Gurtner (C)

Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland.

Martina Dettwiler (M)

Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland.

Anja Schmidt (A)

Vet Med Labor GmbH - Division of IDEXX Laboratories, Ludwigsburg, Germany.

Florian Bartenschlager (F)

Institute of Veterinary Pathology, Freie Universität Berlin, Berlin, Germany.

Sophie Merz (S)

Institute of Veterinary Pathology, Freie Universität Berlin, Berlin, Germany.

Marco Fragoso (M)

Institute of Veterinary Pathology, Freie Universität Berlin, Berlin, Germany.

Olivia Kershaw (O)

Institute of Veterinary Pathology, Freie Universität Berlin, Berlin, Germany.

Robert Klopfleisch (R)

Institute of Veterinary Pathology, Freie Universität Berlin, Berlin, Germany.

Andreas Maier (A)

Pattern Recognition Lab, Computer Science, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.

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