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Register a new userInterpretable Survival Prediction for Colorectal Cancer using Deep Learning
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Deriving interpretable prognostic features from deep-learning-based prognostic histopathology models remains a challenge. In this study, we developed a deep learning system (DLS) for predicting disease specific survival for stage II and III colorectal cancer using 3,652 cases (27,300 slides). When evaluated on two validation datasets containing 1,239 cases (9,340 slides) and 738 cases (7,140 slides) respectively, the DLS achieved a 5-year disease-specific survival AUC of 0.70 (95%CI 0.66-0.73) and 0.69 (95%CI 0.64-0.72), and added significant predictive value to a set of 9 clinicopathologic features. To interpret the DLS, we explored the ability of different human-interpretable features to explain the variance in DLS scores. We observed that clinicopathologic features such as T-category, N-category, and grade explained a small fraction of the variance in DLS scores (R2=18% in both validation sets). Next, we generated human-interpretable histologic features by clustering embeddings from a deep-learning based image-similarity model and showed that they explain the majority of the variance (R2 of 73% to 80%). Furthermore, the clustering-derived feature most strongly associated with high DLS scores was also highly prognostic in isolation. With a distinct visual appearance (poorly differentiated tumor cell clusters adjacent to adipose tissue), this feature was identified by annotators with 87.0-95.5% accuracy. Our approach can be used to explain predictions from a prognostic deep learning model and uncover potentially-novel prognostic features that can be reliably identified by people for future validation studies.
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With the long-term rapid increase in incidences of colorectal cancer (CRC), there is an urgent clinical need to improve risk stratification. The conventional pathology report is usually limited to only a few histopathological features. However, most of the tumor microenvironments used to describe patterns of aggressive tumor behavior are ignored. In this work, we aim to learn histopathological patterns within cancerous tissue regions that can be used to improve prognostic stratification for colorectal cancer. To do so, we propose a self-supervised learning method that jointly learns a representation of tissue regions as well as a metric of the clustering to obtain their underlying patterns. These histopathological patterns are then used to represent the interaction between complex tissues and predict clinical outcomes directly. We furthermore show that the proposed approach can benefit from linear predictors to avoid overfitting in patient outcomes predictions. To this end, we introduce a new well-characterized clinicopathological dataset, including a retrospective collective of 374 patients, with their survival time and treatment information. Histomorphological clusters obtained by our method are evaluated by training survival models. The experimental results demonstrate statistically significant patient stratification, and our approach outperformed the state-of-the-art deep clustering methods.
Microscopic examination of tissues or histopathology is one of the diagnostic procedures for detecting colorectal cancer. The pathologist involved in such an examination usually identifies tissue type based on texture analysis, especially focusing on tumour-stroma ratio. In this work, we automate the task of tissue classification within colorectal cancer histology samples using deep transfer learning. We use discriminative fine-tuning with one-cycle-policy and apply structure-preserving colour normalization to boost our results. We also provide visual explanations of the deep neural networks decision on texture classification. With achieving state-of-the-art test accuracy of 96.2% we also embark on using deployment friendly architecture called SqueezeNet for memory-limited hardware.
We investigated the ability of deep learning models for imaging based HPV status detection. To overcome the problem of small medical datasets we used a transfer learning approach. A 3D convolutional network pre-trained on sports video clips was fine tuned such that full 3D information in the CT images could be exploited. The video pre-trained model was able to differentiate HPV-positive from HPV-negative cases with an area under the receiver operating characteristic curve (AUC) of 0.81 for an external test set. In comparison to a 3D convolutional neural network (CNN) trained from scratch and a 2D architecture pre-trained on ImageNet the video pre-trained model performed best.
Colorectal cancer is a leading cause of death worldwide. However, early diagnosis dramatically increases the chances of survival, for which it is crucial to identify the tumor in the body. Since its imaging uses high-resolution techniques, annotating the tumor is time-consuming and requires particular expertise. Lately, methods built upon Convolutional Neural Networks(CNNs) have proven to be at par, if not better in many biomedical segmentation tasks. For the task at hand, we propose another CNN-based approach, which uses atrous convolutions and residual connections besides the conventional filters. The training and inference were made using an efficient patch-based approach, which significantly reduced unnecessary computations. The proposed AtResUNet was trained on the DigestPath 2019 Challenge dataset for colorectal cancer segmentation with results having a Dice Coefficient of 0.748.
Nasopharyngeal Carcinoma (NPC) is a worldwide malignant epithelial cancer. Survival prediction is a major concern for NPC patients, as it provides early prognostic information that is needed to guide treatments. Recently, deep learning, which leverages Deep Neural Networks (DNNs) to learn deep representations of image patterns, has been introduced to the survival prediction in various cancers including NPC. It has been reported that image-derived end-to-end deep survival models have the potential to outperform clinical prognostic indicators and traditional radiomics-based survival models in prognostic performance. However, deep survival models, especially 3D models, require large image training data to avoid overfitting. Unfortunately, medical image data is usually scarce, especially for Positron Emission Tomography/Computed Tomography (PET/CT) due to the high cost of PET/CT scanning. Compared to Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) providing only anatomical information of tumors, PET/CT that provides both anatomical (from CT) and metabolic (from PET) information is promising to achieve more accurate survival prediction. However, we have not identified any 3D end-to-end deep survival model that applies to small PET/CT data of NPC patients. In this study, we introduced the concept of multi-task leaning into deep survival models to address the overfitting problem resulted from small data. Tumor segmentation was incorporated as an auxiliary task to enhance the models efficiency of learning from scarce PET/CT data. Based on this idea, we proposed a 3D end-to-end Deep Multi-Task Survival model (DeepMTS) for joint survival prediction and tumor segmentation. Our DeepMTS can jointly learn survival prediction and tumor segmentation using PET/CT data of only 170 patients with advanced NPC.
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