Chapter Thirteen - Toward large-scale histopathological image analysis via deep learning

Deep-Hipo: Multi-scale receptive field deep learning for histopathological image analysis.

The second most common type of malignant tumor worldwide is colorectal cancer. Histopathology image analysis offers crucial data for the clinical diagnosis of colorectal cancer. Currently, deep learning techniques are applied to enhance cancer classification and tumor localization in histopathological image analysis. Moreover, traditional deep learning techniques might loss integrated information in the image while evaluating thousands of patches recovered from whole slide images (WSIs). This research proposes a novel colorectal cancer detection network (CCDNet) that combines coordinate attention transformer with atrous convolution. CCDNet first denoises the input histopathological image using a Wiener based Midpoint weighted non-local means filter (WMW-NLM) for guaranteeing precise diagnoses and maintain image features. Also, a novel atrous convolution with coordinate attention transformer (AConvCAT) is introduced, which successfully combines the advantages of two networks to classify colorectal tissue at various scales by capturing local and global information. Further, coordinate attention model is integrated with a Cross-shaped window (CrSWin) transformer for capturing tiny changes in colorectal tissue from multiple angles. The proposed CCDNet achieved accuracy rates of 98.61% and 98.96%, on the colorectal histological image and NCT-CRC-HE-100 K datasets correspondingly. The comparison analysis demonstrates that the suggested framework performed better than the most advanced methods already in use. In hospitals, clinicians can use the proposed CCDNet to verify the diagnosis.

Automated invasive ductal carcinoma detection based using deep transfer learning with whole-slide images

Deep learning (DL) has transformed medical imaging, particularly in the realm of oral cancer (OC) diagnosis using histopathological images. Timely detection of OC is es-sential for enhancing precision medicine and saving lives. However, incorrect diagnosis may impede effective treatment. In this study, we have proposed a DL model for OC classification, enhanced diagnosis decision-making and interpretability. We achieve this by starting with colour normalisation of histopathology images using the Vaha-dane 3-stain parameter normalisation and watershed segmentation method, followed by tiling and augmentation. Key features are selected using the weighted Fisher score (WFS) to address class imbalance. The U-Net classifier has been improved by using feature-based inputs instead of full images, reducing computational complexity and training time. The integration of Vahadane normalisation for consistent preprocessing across samples, WFS, and explainable artificial intelligence (XAI) addresses critical challenges in histopathological image analysis. The proposed model surpasses exist-ing approaches with a classification accuracy of 99.54%, and it outperforms Dense- Net201 and VGG10 in precision and reliability. The efficiency in handling imbal-anced datasets and explainability features make it suitable for early precise OC detec-tion, which can reduce diagnostic errors and enhance treatment outcomes.

The increasing adoption of the whole slide image (WSI) technology in histopathology has dramatically transformed pathologists' workflow and allowed the use of computer systems in histopathology analysis. Extensive research in Artificial Intelligence (AI) with a huge progress has been conducted resulting in efficient, effective, and robust algorithms for several applications including cancer diagnosis, prognosis, and treatment. These algorithms offer highly accurate predictions but lack transparency, understandability, and actionability. Thus, explainable artificial intelligence (XAI) techniques are needed not only to understand the mechanism behind the decisions made by AI methods and increase user trust but also to broaden the use of AI algorithms in the clinical setting. From the survey of over 150 papers, we explore different AI algorithms that have been applied and contributed to the histopathology image analysis workflow. We first address the workflow of the histopathological process. We present an overview of various learning‐based, XAI, and actionable techniques relevant to deep learning methods in histopathological imaging. We also address the evaluation of XAI methods and the need to ensure their reliability on the field.This article is categorized under:Application Areas > Health Care

Artificial Intelligence-Powered Digital Pathology to Improve Diagnosis and Personalized Prognostic Assessment in Patient with Myeloid Neoplasms

Breast cancer is one of the most common types of cancer in women, and histopathological imaging is considered the gold standard for its diagnosis. However, the great complexity of histopathological images and the considerable workload make this work extremely time-consuming, and the results may be affected by the subjectivity of the pathologist. Therefore, the development of an accurate, automated method for analysis of histopathological images is critical to this field. In this article, we propose a deep learning method guided by the attention mechanism for fast and effective classification of haematoxylin and eosin-stained breast biopsy images. First, this method takes advantage of DenseNet and uses the feature map's information. Second, we introduce dilated convolution to produce a larger receptive field. Finally, spatial attention and channel attention are used to guide the extraction of the most useful visual features. With the use of fivefold cross-validation, the best model obtained an accuracy of 96.47% on the BACH2018 dataset. We also evaluated our method on other datasets, and the experimental results demonstrated that our model has reliable performance. This study indicates that our histopathological image classifier with a soft attention-guided deep learning model for breast cancer shows significantly better results than the latest methods. It has great potential as an effective tool for automatic evaluation of digital histopathological microscopic images for computer-aided diagnosis.

This article provides an overview of computer-assisted techniques (CAT) used to assess histopathological images for Breast cancer. The Histopathological images analysis (HIPA) is time consuming and challenging. The shape, size, color and crowding of nuclei disclose important statistics about the tissue health. For diagnosis of cancer, nuclei are an important attribute which has to be isolated from other healthy tissues followed by feature extraction which is the primary and the most critical step. In order to distinguish between tumor or cancer types, experts assess morphometric features of each and every cell and their nuclei. The most familiar steps in histopathological image analysis like stain normalization, segmentation, feature extraction and classification are covered in this review. The segmentation methods of H & E images and several challenges related to stain normalization are discussed. Since stain normalization is a stage in the pre-processing of H & E images and the first step of feature extraction. In a nutshell, this article will outline different methods for analysing breast pathology images.

BackgroundTargeted therapy and immunotherapy put forward higher demands for accurate lung cancer classification, as well as benign versus malignant disease discrimination. Digital whole slide images (WSIs) witnessed the transition from traditional histopathology to computational approaches, arousing a hype of deep learning methods for histopathological analysis. We aimed at exploring the potential of deep learning models in the identification of lung cancer subtypes and cancer mimics from WSIs.MethodsWe initially obtained 741 WSIs from the First Affiliated Hospital of Sun Yat-sen University (SYSUFH) for the deep learning model development, optimization, and verification. Additional 318 WSIs from SYSUFH, 212 from Shenzhen People’s Hospital, and 422 from The Cancer Genome Atlas were further collected for multi-centre verification. EfficientNet-B5- and ResNet-50-based deep learning methods were developed and compared using the metrics of recall, precision, F1-score, and areas under the curve (AUCs). A threshold-based tumour-first aggregation approach was proposed and implemented for the label inferencing of WSIs with complex tissue components. Four pathologists of different levels from SYSUFH reviewed all the testing slides blindly, and the diagnosing results were used for quantitative comparisons with the best performing deep learning model.ResultsWe developed the first deep learning-based six-type classifier for histopathological WSI classification of lung adenocarcinoma, lung squamous cell carcinoma, small cell lung carcinoma, pulmonary tuberculosis, organizing pneumonia, and normal lung. The EfficientNet-B5-based model outperformed ResNet-50 and was selected as the backbone in the classifier. Tested on 1067 slides from four cohorts of different medical centres, AUCs of 0.970, 0.918, 0.963, and 0.978 were achieved, respectively. The classifier achieved high consistence to the ground truth and attending pathologists with high intraclass correlation coefficients over 0.873.ConclusionsMulti-cohort testing demonstrated our six-type classifier achieved consistent and comparable performance to experienced pathologists and gained advantages over other existing computational methods. The visualization of prediction heatmap improved the model interpretability intuitively. The classifier with the threshold-based tumour-first label inferencing method exhibited excellent accuracy and feasibility in classifying lung cancers and confused nonneoplastic tissues, indicating that deep learning can resolve complex multi-class tissue classification that conforms to real-world histopathological scenarios.

With the development of artificial intelligence, whole-slide image technology is gradually applied to computer-aided diagnosis. To improve the accuracy and objectivity of histopathological image analysis, whole-slide image technology to detect histopathological images began to be used. In this paper, we present a brief review of detection methods in whole-slide image based on computer-aided diagnosis, and then we summarize, analyze these methods to find a suitable algorithm for detecting.

BackgroundMany methodologies for selecting histopathological images, such as sample image patches or segment histology from regions of interest (ROIs) or whole-slide images (WSIs), have been utilized to develop survival models. With gigapixel WSIs exhibiting diverse histological appearances, obtaining clinically prognostic and explainable features remains challenging. Therefore, we propose a novel deep learning-based algorithm combining tissue areas with histopathological features to predict cancer survival.MethodsThe Cancer Genome Atlas Colon Adenocarcinoma (TCGA-COAD) dataset was used in this investigation. A deep convolutional survival model (DeepConvSurv) extracted histopathological information from the image patches of nine different tissue types, including tumors, lymphocytes, stroma, and mucus. The tissue map of the WSIs was segmented using image processing techniques that involved localizing and quantifying the tissue region. Six survival models with the concordance index (C-index) were used as the evaluation metrics.ResultsWe extracted 128 histopathological features from four histological types and five tissue area features from WSIs to predict colorectal cancer survival. Our method performed better in six distinct survival models than the Whole Slide Histopathological Images Survival Analysis framework (WSISA), which adaptively sampled patches using K-means from WSIs. The best performance using histopathological features was 0.679 using LASSO-Cox. Compared to histopathological features alone, tissue area features increased the C-index by 2.5%. Based on histopathological features and tissue area features, our approach achieved performance of 0.704 with RIDGE-Cox.ConclusionsA deep learning-based algorithm combining histopathological features with tissue area proved clinically relevant and effective for predicting cancer survival.

Recently, artificial intelligence (AI) is an extremely revolutionized domain of medical image processing. Specifically, image segmentation is a task that generally aids in such an improvement. This boost performs great developments in the conversion of AI approaches in the research lab to real medical applications, particularly for computer-aided diagnosis (CAD) and image-guided operation. Mitotic nuclei estimates in breast cancer instances have a prognostic impact on diagnosis of cancer aggressiveness and grading methods. The automated analysis of mitotic nuclei is difficult due to its high similarity with nonmitotic nuclei and heteromorphic form. This study designs an artificial hummingbird algorithm with transfer-learning-based mitotic nuclei classification (AHBATL-MNC) on histopathologic breast cancer images. The goal of the AHBATL-MNC technique lies in the identification of mitotic and nonmitotic nuclei on histopathology images (HIs). For HI segmentation process, the PSPNet model is utilized to identify the candidate mitotic patches. Next, the residual network (ResNet) model is employed as feature extractor, and extreme gradient boosting (XGBoost) model is applied as a classifier. To enhance the classification performance, the parameter tuning of the XGBoost model takes place by making use of the AHBA approach. The simulation values of the AHBATL-MNC system are tested on medical imaging datasets and the outcomes are investigated in distinct measures. The simulation values demonstrate the enhanced outcomes of the AHBATL-MNC method compared to other current approaches.

Introduction/Objective Recent advancements in artificial intelligence (AI), particularly with Large Language Models like ChatGPT-4Vision (GPT-4V), have expanded the potential for automated interpretation of medical images. This study evaluates the diagnostic accuracy of GPT-4V in histopathological analysis of neurodegenerative diseases and compares its performance with traditional Convolutional Neural Networks (CNNs). Methods/Case Report We utilized 1515 histopathological images, including hematoxylin and eosin (H&E) staining and tau immunohistochemistry, from patients with various neurodegenerative diseases, such as Alzheimer’s disease, progressive supranuclear palsy, and corticobasal degeneration. GPT-4V’s performance was assessed through multi- step prompts to assess how textual context influences the image interpretation. In the quantitative analysis, the diagnostic accuracy of GPT-4V and the CNN-based model YOLOv8 was assessed for classifying three tau lesions—astrocytic plaques, neuritic plaques, and tufted astrocytes. The analysis used both zero-shot and few-shot learning methods, where GPT-4V and YOLOv8 were evaluated on their ability to distinguish these lesions using ten hold-out test images and 490 training images per lesion. Results (if a Case Study enter NA) GPT-4V accurately recognized Lewy bodies in all cases, but it showed limited accuracy in identifying neurofibrillary tangles (20%) and Pick bodies (0%) on H&E slides. Notably, GPT-4V often suggested Alzheimer’s disease as a potential diagnosis, relying more on contextual clues, such as the prevalence of certain diseases, rather than direct image analysis. In the tau immunohistochemical analysis, GPT-4V’s diagnoses were strongly influenced by additional information about staining and brain region. However, few-shot learning markedly improved GPT-4V’s diagnostic capabilities from 40% accuracy with zero-shot learning to 90% with few-shot learning, reaching best accuracy with 20-shot learning. This performance compared favorably against YOLOv8, which also achieved 90% accuracy but required 100-shot learning. Conclusion While GPT-4V faces challenges in independently interpreting histopathological images, few-shot learning significantly improves its accuracy. This approach is particularly promising for neuropathology, where acquiring extensive labeled datasets is challenging. The findings highlight the need for ongoing refinement of AI applications in pathology, emphasizing balanced integration of textual and visual data to optimize diagnostic efficacy and reliability.

Recent advances in machine learning are transforming medical image analysis, particularly in cancer detection and classification. Techniques such as deep learning, especially convolutional neural networks (CNNs) and vision transformers (ViTs), are now enabling the precise analysis of complex histopathological images, automating detection, and enhancing classification accuracy across various cancer types. This study focuses on osteosarcoma (OS), the most common bone cancer in children and adolescents, which affects the long bones of the arms and legs. Early and accurate detection of OS is essential for improving patient outcomes and reducing mortality. However, the increasing prevalence of cancer and the demand for personalized treatments create challenges in achieving precise diagnoses and customized therapies. We propose a novel hybrid model that combines convolutional neural networks (CNN) and vision transformers (ViT) to improve diagnostic accuracy for OS using hematoxylin and eosin (H&E) stained histopathological images. The CNN model extracts local features, while the ViT captures global patterns from histopathological images. These features are combined and classified using a Multi-Layer Perceptron (MLP) into four categories: non-tumor (NT), non-viable tumor (NVT), viable tumor (VT), and non-viable ratio (NVR). Using the Cancer Imaging Archive (TCIA) dataset, the model achieved an accuracy of 99.08%, precision of 99.10%, recall of 99.28%, and an F1-score of 99.23%. This is the first successful four-class classification using this dataset, setting a new benchmark in OS research and offering promising potential for future diagnostic advancements.

Importance of complementary data to histopathological image analysis of oral leukoplakia and carcinoma using deep neural networks