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Register a new userA Dilated Residual Hierarchically Fashioned Segmentation Framework for Extracting Gleason Tissues and Grading Prostate Cancer from Whole Slide Images
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Prostate cancer (PCa) is the second deadliest form of cancer in males, and it can be clinically graded by examining the structural representations of Gleason tissues. This paper proposes RV{a new method} for segmenting the Gleason tissues RV{(patch-wise) in order to grade PCa from the whole slide images (WSI).} Also, the proposed approach encompasses two main contributions: 1) A synergy of hybrid dilation factors and hierarchical decomposition of latent space representation for effective Gleason tissues extraction, and 2) A three-tiered loss function which can penalize different semantic segmentation models for accurately extracting the highly correlated patterns. In addition to this, the proposed framework has been extensively evaluated on a large-scale PCa dataset containing 10,516 whole slide scans (with around 71.7M patches), where it outperforms state-of-the-art schemes by 3.22% (in terms of mean intersection-over-union) for extracting the Gleason tissues and 6.91% (in terms of F1 score) for grading the progression of PCa.
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Gleason grading of prostate cancer is an important prognostic factor but suffers from poor reproducibility, particularly among non-subspecialist pathologists. Although artificial intelligence (A.I.) tools have demonstrated Gleason grading on-par with expert pathologists, it remains an open question whether A.I. grading translates to better prognostication. In this study, we developed a system to predict prostate-cancer specific mortality via A.I.-based Gleason grading and subsequently evaluated its ability to risk-stratify patients on an independent retrospective cohort of 2,807 prostatectomy cases from a single European center with 5-25 years of follow-up (median: 13, interquartile range 9-17). The A.I.s risk scores produced a C-index of 0.84 (95%CI 0.80-0.87) for prostate cancer-specific mortality. Upon discretizing these risk scores into risk groups analogous to pathologist Grade Groups (GG), the A.I. had a C-index of 0.82 (95%CI 0.78-0.85). On the subset of cases with a GG in the original pathology report (n=1,517), the A.I.s C-indices were 0.87 and 0.85 for continuous and discrete grading, respectively, compared to 0.79 (95%CI 0.71-0.86) for GG obtained from the reports. These represent improvements of 0.08 (95%CI 0.01-0.15) and 0.07 (95%CI 0.00-0.14) respectively. Our results suggest that A.I.-based Gleason grading can lead to effective risk-stratification and warrants further evaluation for improving disease management.
Histology review is often used as the `gold standard for disease diagnosis. Computer aided diagnosis tools can potentially help improve current pathology workflows by reducing examination time and interobserver variability. Previous work in cancer grading has focused mainly on classifying pre-defined regions of interest (ROIs), or relied on large amounts of fine-grained labels. In this paper, we propose a two-stage attention-based multiple instance learning model for slide-level cancer grading and weakly-supervised ROI detection and demonstrate its use in prostate cancer. Compared with existing Gleason classification models, our model goes a step further by utilizing visualized saliency maps to select informative tiles for fine-grained grade classification. The model was primarily developed on a large-scale whole slide dataset consisting of 3,521 prostate biopsy slides with only slide-level labels from 718 patients. The model achieved state-of-the-art performance for prostate cancer grading with an accuracy of 85.11% for classifying benign, low-grade (Gleason grade 3+3 or 3+4), and high-grade (Gleason grade 4+3 or higher) slides on an independent test set.
Automatic and accurate Gleason grading of histopathology tissue slides is crucial for prostate cancer diagnosis, treatment, and prognosis. Usually, histopathology tissue slides from different institutions show heterogeneous appearances because of different tissue preparation and staining procedures, thus the predictable model learned from one domain may not be applicable to a new domain directly. Here we propose to adopt unsupervised domain adaptation to transfer the discriminative knowledge obtained from the source domain to the target domain without requiring labeling of images at the target domain. The adaptation is achieved through adversarial training to find an invariant feature space along with the proposed Siamese architecture on the target domain to add a regularization that is appropriate for the whole-slide images. We validate the method on two prostate cancer datasets and obtain significant classification improvement of Gleason scores as compared with the baseline models.
Convolutional neural networks have led to significant breakthroughs in the domain of medical image analysis. However, the task of breast cancer segmentation in whole-slide images (WSIs) is still underexplored. WSIs are large histopathological images with extremely high resolution. Constrained by the hardware and field of view, using high-magnification patches can slow down the inference process and using low-magnification patches can cause the loss of information. In this paper, we aim to achieve two seemingly conflicting goals for breast cancer segmentation: accurate and fast prediction. We propose a simple yet efficient framework Reinforced Auto-Zoom Net (RAZN) to tackle this task. Motivated by the zoom-in operation of a pathologist using a digital microscope, RAZN learns a policy network to decide whether zooming is required in a given region of interest. Because the zoom-in action is selective, RAZN is robust to unbalanced and noisy ground truth labels and can efficiently reduce overfitting. We evaluate our method on a public breast cancer dataset. RAZN outperforms both single-scale and multi-scale baseline approaches, achieving better accuracy at low inference cost.
The Gleason grading system using histological images is the most powerful diagnostic and prognostic predictor of prostate cancer. The current standard inspection is evaluating Gleason H&E-stained histopathology images by pathologists. However, it is complicated, time-consuming, and subject to observers. Deep learning (DL) based-methods that automatically learn image features and achieve higher generalization ability have attracted significant attention. However, challenges remain especially using DL to train the whole slide image (WSI), a predominant clinical source in the current diagnostic setting, containing billions of pixels, morphological heterogeneity, and artifacts. Hence, we proposed a convolutional neural network (CNN)-based automatic classification method for accurate grading of PCa using whole slide histopathology images. In this paper, a data augmentation method named Patch-Based Image Reconstruction (PBIR) was proposed to reduce the high resolution and increase the diversity of WSIs. In addition, a distribution correction (DC) module was developed to enhance the adaption of pretrained model to the target dataset by adjusting the data distribution. Besides, a Quadratic Weighted Mean Square Error (QWMSE) function was presented to reduce the misdiagnosis caused by equal Euclidean distances. Our experiments indicated the combination of PBIR, DC, and QWMSE function was necessary for achieving superior expert-level performance, leading to the best results (0.8885 quadratic-weighted kappa coefficient).
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